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General NPI Number Information
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NPI Number | 1013078286
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Entity Type | Individual
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Provider Name | IMTIAZ ZAMAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 805 RODMAN AVE
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City | PORTSMOUTH
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State | VA
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Zip | 23707-3119
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Country | US
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Telephone | 757-399-1970
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Fax | 757-436-3460
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Provider Business Mailing Address
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Address Line | PO BOX 9886
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City | CHESAPEAKE
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State | VA
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Zip | 23321-0886
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Country | US
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Telephone | 757-436-2620
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Fax | 757-436-3460
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101048628
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License Number State | VA
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