Provider Demographics
NPI: | 1376722496 |
---|---|
Name: | ZAHALSKY, HOWARD PERRY (MD) |
Entity Type: | Individual |
Prefix: | MR |
First Name: | HOWARD |
Middle Name: | PERRY |
Last Name: | ZAHALSKY |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1715 N GEORGE MASON DR |
Mailing Address - Street 2: | SUITE 501 |
Mailing Address - City: | ARLINGTON |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22205-3609 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 703-525-4103 |
Mailing Address - Fax: | 703-525-4106 |
Practice Address - Street 1: | 1715 N GEORGE MASON DR |
Practice Address - Street 2: | SUITE 501 |
Practice Address - City: | ARLINGTON |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22205-3609 |
Practice Address - Country: | US |
Practice Address - Phone: | 703-525-4103 |
Practice Address - Fax: | 703-525-4106 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-10-25 |
Last Update Date: | 2007-10-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0101055699 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
VA | 5867436 | Medicaid | |
VA | 1263242 | Other | CIGNA |
VA | F4120001 | Other | CAREFIRST |
VA | 2122458 | Other | MAMSI |
VA | 453964 | Other | ANTHEM |
VA | F4120001 | Other | CAREFIRST |