1417920802 NPI number — DR. DAVID A ZOLL PHD

Table of content: DR. DAVID A ZOLL PHD (NPI 1417920802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417920802 NPI number — DR. DAVID A ZOLL PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZOLL
Provider First Name:
DAVID
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
M

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1417920802
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
780 LYNNHAVEN PKWY
Provider Second Line Business Mailing Address:
STE 400
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23452-7332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-468-0550
Provider Business Mailing Address Fax Number:
757-468-9992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
780 LYNNHAVEN PKWY
Provider Second Line Business Practice Location Address:
STE 400 ATLANTIC PSYCHIATRIC SERVICES
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23452-7332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-468-0550
Provider Business Practice Location Address Fax Number:
757-468-9992
Provider Enumeration Date:
02/08/2006

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: 103TC0700X , with the licence number:  0810001462 , 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: 007781 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 046314 . This is a "ANTHEM HEALTH KEEPERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 087130 . This is a "SENTARA OPTIMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 213528 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: C02527 . This is a "MCARE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 234202 . This is a "COM PSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 459623 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 046314 . This is a "ANTHEM PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 133105 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 046314 . This is a "BC BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36766905 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60052 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00129371 . This is a "MCARE RAILROAD" identifier . This identifiers is of the category "OTHER".




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