Healthcare Provider Details
I. General information
NPI: 1598744229
Provider Name (Legal Business Name): ZACHERIA CHERIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/11/2006
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 IRVING ST NW RM 5B-17
WASHINGTON DC
20010-2976
US
IV. Provider business mailing address
1494 OLD ASHGROVE
VIENNA VA
22182
US
V. Phone/Fax
- Phone: 202-877-6527
- Fax:
- Phone: 703-442-0288
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD12199 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | MD12199 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: