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General NPI Number Information
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NPI Number | 1679676720
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Entity Type | Individual
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Provider Name | JEFFERSON BO ZI LIN MD
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 225 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-452-3467
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Fax | 757-452-3466
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Provider Business Mailing Address
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Address Line | 225 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-452-3467
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Fax | 757-452-3466
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 0101237705
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | L8416
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 36113473
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 33944
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License Number State | AZ
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