Provider Demographics
NPI:1205872264
Name:ZAKHARY, BOSHRA GEORGE (MD)
Entity type:Individual
Prefix:
First Name:BOSHRA
Middle Name:GEORGE
Last Name:ZAKHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S MAIN ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2938
Mailing Address - Country:US
Mailing Address - Phone:434-792-9110
Mailing Address - Fax:434-799-6074
Practice Address - Street 1:201 S MAIN ST STE 1100
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2938
Practice Address - Country:US
Practice Address - Phone:434-792-9110
Practice Address - Fax:434-799-6074
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044807207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006028039Medicaid
VA065383OtherANTHEM
E30628Medicare UPIN
110003701Medicare ID - Type Unspecified