Provider Demographics
NPI:1841295441
Name:ZAMBRANA, BENJAMIN FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:FRANKLIN
Last Name:ZAMBRANA
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 1:4405 FOREST HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3241
Mailing Address - Country:US
Mailing Address - Phone:804-233-9661
Mailing Address - Fax:804-233-1101
Practice Address - Street 1:4405 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-3241
Practice Address - Country:US
Practice Address - Phone:804-233-9661
Practice Address - Fax:804-233-1101
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101021333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005634041Medicaid
VA081075OtherANTHEM BCBS OF VA
VA1841295441Medicaid
VAB59587Medicare UPIN
VA1841295441Medicaid
VA005634041Medicaid
VA081075OtherANTHEM BCBS OF VA
P00779127Medicare PIN