Healthcare Provider Details

I. General information

NPI: 1114012150
Provider Name (Legal Business Name): ZERLINE E CHAMBERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3775 FETTLER PARK DR
DUMFRIES VA
22025-2119
US

IV. Provider business mailing address

3775 FETTLER PARK DR
DUMFRIES VA
22025-2119
US

V. Phone/Fax

Practice location:
  • Phone: 703-441-3555
  • Fax: 703-441-3557
Mailing address:
  • Phone: 703-441-3555
  • Fax: 703-441-3557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0101039281
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: