Provider Demographics
NPI:1225185762
Name:ZERLINE CHAMBERS-KERSEY MD PC
Entity Type:Organization
Organization Name:ZERLINE CHAMBERS-KERSEY MD PC
Other - Org Name:ZERLINE CHAMBERS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER-OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZERLINE
Authorized Official - Middle Name:EVELYN
Authorized Official - Last Name:CHAMBERS-KERSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-441-3555
Mailing Address - Street 1:3775 FETTLER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1946
Mailing Address - Country:US
Mailing Address - Phone:703-441-3555
Mailing Address - Fax:703-441-3557
Practice Address - Street 1:3775 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1946
Practice Address - Country:US
Practice Address - Phone:703-441-3555
Practice Address - Fax:703-441-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039281261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006207481Medicaid
VA160001309Medicare ID - Type Unspecified
VA006207481Medicaid