Provider Demographics
NPI:1588665962
Name:ZINN, EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:ZINN
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 1:333 S GLEBE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1639
Mailing Address - Country:US
Mailing Address - Phone:703-524-6942
Mailing Address - Fax:
Practice Address - Street 1:333 S GLEBE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1639
Practice Address - Country:US
Practice Address - Phone:703-524-6942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010209742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
168318Medicare ID - Type Unspecified
B93939Medicare UPIN