Provider Demographics
NPI:1386690220
Name:SHOOK, ZACHARY M (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:M
Last Name:SHOOK
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:PO BOX 28780
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-8780
Mailing Address - Country:US
Mailing Address - Phone:804-346-1515
Mailing Address - Fax:804-273-6052
Practice Address - Street 1:6900 FOREST AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1729
Practice Address - Country:US
Practice Address - Phone:804-346-1515
Practice Address - Fax:804-273-6052
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1320413OtherAETNA HMO
VA438929OtherSOUTHERN HEALTH
VA2156818OtherUNITED HEALTHCARE
VA010275008Medicaid
VA10009093OtherOPTIMA
VA193376OtherANTHEM BCBS
VA7975750OtherAETNA NON-HMO
VA193376OtherANTHEM BCBS
VA1320413OtherAETNA HMO
VA010198V24Medicare PIN
VA7975750OtherAETNA NON-HMO
VACB4715Medicare Oscar/Certification