Provider Demographics
NPI:1417920802
Name:ZOLL, DAVID A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:ZOLL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 LYNNHAVEN PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7332
Mailing Address - Country:US
Mailing Address - Phone:757-468-0550
Mailing Address - Fax:757-468-9992
Practice Address - Street 1:780 LYNNHAVEN PKWY
Practice Address - Street 2:STE 400 ATLANTIC PSYCHIATRIC SERVICES
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7332
Practice Address - Country:US
Practice Address - Phone:757-468-0550
Practice Address - Fax:757-468-9992
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
007781OtherVALUE OPTIONS
046314OtherANTHEM HEALTH KEEPERS
087130OtherSENTARA OPTIMA
213528OtherMAMSI
C02527OtherMCARE GROUP
234202OtherCOM PSYCH
459623OtherMAGELLAN
046314OtherANTHEM PPO
133105OtherMANAGED HEALTH NETWORK
046314OtherBC BS
36766905OtherMULTIPLAN
60052OtherCIGNA
P00129371OtherMCARE RAILROAD
046314OtherANTHEM PPO