Provider Demographics
NPI:1649256181
Name:ZAZAKOS, CHRISTOPHER P JR (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:ZAZAKOS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:590 PETER JEFFERSON PLACE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-0001
Mailing Address - Country:US
Mailing Address - Phone:434-982-6900
Mailing Address - Fax:434-982-8420
Practice Address - Street 1:590 PETER JEFFERSON PLACE
Practice Address - Street 2:SUITE 175
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-0001
Practice Address - Country:US
Practice Address - Phone:434-982-6900
Practice Address - Fax:434-982-8420
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101029807207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006021760Medicaid
VA110026248OtherMEDICARE RAILROAD
VA006070191Medicaid
VA110117309OtherMEDICARE RAILROAD /AMC
VA110000959Medicare PIN
B62099Medicare UPIN