David L. Zisow, M.D.,L.L.C.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

D0017174 Issued in MD

Legal business name

DAVID L. ZISOW, M.D.,L.L.C.

Practice address

2005 Rock Spring Rd
Suite 3
Forest Hill, MD 21050-2621

Phone

(410) 879-1139

Fax

(410) 893-1158

NPI assigned

Mar 5, 2008

Last updated

Mar 5, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Karen Lynn Hannah

Title

Office MGR

Phone

(410) 879-1139

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1316117302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ROCK SPRING RD",
            "address_2": "SUITE 3",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502621",
            "telephone_number": "410-879-1139",
            "fax_number": "410-893-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ROCK SPRING RD",
            "address_2": "SUITE 3",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502621",
            "telephone_number": "410-879-1139",
            "fax_number": "410-893-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L. ZISOW, M.D.,L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "HANNAH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "410-879-1139"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MD",
            "license": "D0017174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Forest Hill, MD
• Providers in Forest Hill, MD by specialty
• Community Health Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.