Healthcare Provider Details

I. General information

NPI: 1841879657
Provider Name (Legal Business Name): LOUAY ZUMOT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10432 PATRIOT HWY
FREDERICKSBURG VA
22408-2628
US

IV. Provider business mailing address

10432 PATRIOT HWY
FREDERICKSBURG VA
22408-2628
US

V. Phone/Fax

Practice location:
  • Phone: 540-707-7074
  • Fax:
Mailing address:
  • Phone: 540-707-7074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number0101286555
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: