MEDICARE: DR. BENJAMIN FRANKLIN ZAMBRANA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101021333	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	081075	OTHER	VA	ANTHEM BCBS OF VA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841295441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN FRANKLIN ZAMBRANA M.D.

Provider Business Mailing Address
First Line	:	4405 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-3241
Country	:	US
Telephone Number	:	804-233-9661
Fax Number	:	804-233-1101

Provider Business Practice Location Address
First Line	:	4405 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-3241
Country	:	US
Telephone Number	:	804-233-9661
Fax Number	:	804-233-1101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	02/03/2010

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