Provider Demographics
NPI:1174582860
Name:CHATTLER, ZACHARY LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:LEE
Last Name:CHATTLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 SAFFELL RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-6030
Mailing Address - Country:US
Mailing Address - Phone:410-583-2877
Mailing Address - Fax:
Practice Address - Street 1:10753 FALLS RD
Practice Address - Street 2:SUITE 265
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4535
Practice Address - Country:US
Practice Address - Phone:410-583-2877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00965213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT88911Medicare UPIN
MD123NMedicare ID - Type Unspecified