Healthcare Provider Details

I. General information

NPI: 1619537222
Provider Name (Legal Business Name): MIAN ZEESHAN MUNIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SENTARA CIR STE 201A
WILLIAMSBURG VA
23188-5716
US

IV. Provider business mailing address

825 FAIRFAX AVE
NORFOLK VA
23507-1914
US

V. Phone/Fax

Practice location:
  • Phone: 757-827-2127
  • Fax:
Mailing address:
  • Phone: 757-446-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101275074
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101275074
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101275074
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: