Individual
MR. DAVID ALLEN ZELLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS PA-C, APA, CCHP
Contact information
Practice address
2480 LLEWELLYN AVE STE 5800, FORT MEADE, MD 20755-5129
(253) 677-7655
Mailing address
PO BOX 1084, BRANDON, FL 33509-1084
(253) 677-7655
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C07116
MD
363A00000X
Physician Assistant
PA60277854
WA
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C07116
PHYSICIAN ASSISTANT LICENSE, MARYLAND
MD
01
—
PA60277854
PHYSICIAN ASSISTANT LICENSE, WASHINGTON STATE
WA
Enumeration date
12/06/2006
Last updated
10/27/2020
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