Provider Demographics
NPI:1700813334
Name:ZINSSER, JOHN WILLLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLLIAM
Last Name:ZINSSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1501 MAPLE AVE
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2553
Mailing Address - Country:US
Mailing Address - Phone:804-474-9805
Mailing Address - Fax:804-474-9810
Practice Address - Street 1:1501 MAPLE AVE
Practice Address - Street 2:SUITE 101B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2553
Practice Address - Country:US
Practice Address - Phone:804-474-9805
Practice Address - Fax:804-474-9810
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010576212086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1700813334Medicaid
VAF78818Medicare UPIN
VA00X401Z01Medicare PIN