Provider Demographics
NPI:1952613838
Name:ZICHAL, ERNEST FRANCIS (DO)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:FRANCIS
Last Name:ZICHAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 J CLYDE MORRIS BLVD
Practice Address - Street 2:SUITE 603
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1929
Practice Address - Country:US
Practice Address - Phone:757-534-5340
Practice Address - Fax:757-594-3456
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2013-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01022031512086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952613333Medicaid
VAVV6410AMedicare PIN
VA1952613333Medicaid