Healthcare Provider Details

I. General information

NPI: 1700813334
Provider Name (Legal Business Name): JOHN WILLLIAM ZINSSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MAPLE AVE SUITE 101B
RICHMOND VA
23226-2553
US

IV. Provider business mailing address

1501 MAPLE AVE SUITE 101B
RICHMOND VA
23226-2553
US

V. Phone/Fax

Practice location:
  • Phone: 804-474-9805
  • Fax: 804-474-9810
Mailing address:
  • Phone: 804-474-9805
  • Fax: 804-474-9810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number0101057621
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: