Provider Demographics
NPI:1396883740
Name:ALBERT, ZACHARY IRA (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:IRA
Last Name:ALBERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U S MARINE CORPS FORCES COMMAND HEALTH SERVICES SUPPOR
Mailing Address - Street 2:1468 INGRAM STREET
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23551-2596
Mailing Address - Country:US
Mailing Address - Phone:757-836-1685
Mailing Address - Fax:
Practice Address - Street 1:U S MARINE CORPS FORCES COMMAND HEALTH SERVICES SUPPOR
Practice Address - Street 2:1468 INGRAM STREET
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23551-2596
Practice Address - Country:US
Practice Address - Phone:757-836-1685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01351208D00000X
CODR.0056625207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice