Healthcare Provider Details

I. General information

NPI: 1730183484
Provider Name (Legal Business Name): GARY REUBEN ZEEVI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 BREMO RD MOB SOUTH, SUITE G-5
RICHMOND VA
23226-1934
US

IV. Provider business mailing address

600 GRESHAM DR MOB SOUTH, SUITE G-5
NORFOLK VA
23507-1904
US

V. Phone/Fax

Practice location:
  • Phone: 804-287-7840
  • Fax: 804-287-7845
Mailing address:
  • Phone: 757-388-3934
  • Fax: 757-388-2957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101038086
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101038086
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: