Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D83411 | MD |
NPI | 1194082115 |
---|---|
Provider Name | Dr. Ralph Thomas Zade III |
First Address | Catonsville, MD 21228-4516 |
Second Address | Catonsville, MD 21228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2012 |
Last Update Date | 30/05/2018 |