Healthcare Provider Details

I. General information

NPI: 1417330036
Provider Name (Legal Business Name): DAVID CHRISTOPHER ZUPRUK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRESHAM DR STE 204
NORFOLK VA
23507-1904
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US

V. Phone/Fax

Practice location:
  • Phone: 757-388-5680
  • Fax: 757-388-5681
Mailing address:
  • Phone: 614-544-1401
  • Fax: 614-544-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOT016520
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34.014506
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number34.014506
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number0102206782
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: