Healthcare Provider Details

I. General information

NPI: 1164415964
Provider Name (Legal Business Name): JEFFREY J ZURAVLEFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 WILKES RIDGE PKWY SUITE 102
RICHMOND VA
23233-7429
US

IV. Provider business mailing address

1630 WILKES RIDGE PKWY SUITE 102
RICHMOND VA
23233-7429
US

V. Phone/Fax

Practice location:
  • Phone: 804-934-9344
  • Fax: 804-934-9034
Mailing address:
  • Phone: 804-934-9344
  • Fax: 804-934-9034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101046909
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: