Provider Demographics
NPI:1568525392
Name:CHRIS, Z (MD)
Entity Type:Individual
Prefix:DR
First Name:Z
Middle Name:
Last Name:CHRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ZESES
Other - Middle Name:CHRIS
Other - Last Name:ROULIDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1800 N BEAUREGARD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1735
Mailing Address - Country:US
Mailing Address - Phone:703-933-8111
Mailing Address - Fax:703-379-3965
Practice Address - Street 1:1800 N BEAUREGARD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1735
Practice Address - Country:US
Practice Address - Phone:703-933-8111
Practice Address - Fax:703-379-3965
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048596207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E87984Medicare UPIN