Healthcare Provider Details

I. General information

NPI: 1073191334
Provider Name (Legal Business Name): MICHELLE XIYING ZUCHERMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 JOSEPH SIEWICK DR STE 203
FAIRFAX VA
22033-1756
US

IV. Provider business mailing address

4030 LAKE GLEN RD
FAIRFAX VA
22033-4379
US

V. Phone/Fax

Practice location:
  • Phone: 703-941-0267
  • Fax:
Mailing address:
  • Phone: 415-374-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102208493
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: