1285647388 NPI number — SHIRIN F ZEV M.D.

Table of content: SHIRIN F ZEV M.D. (NPI 1285647388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285647388 NPI number — SHIRIN F ZEV M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEV
Provider First Name:
SHIRIN
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FATEMA
Provider Other First Name:
SHIRIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285647388
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2994 CHURCHLAND BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23321-5643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-484-0500
Provider Business Mailing Address Fax Number:
757-686-2805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2994 CHURCHLAND BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23321-5643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-484-0500
Provider Business Practice Location Address Fax Number:
757-686-2805
Provider Enumeration Date:
08/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  0101237364 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00245033 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 173740 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2133072 . This is a "ALLIANCE OPTIMUM CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010134528 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0408624 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10001833 . This is a "OPTIMA" identifier . This identifiers is of the category "OTHER".