Provider Demographics
NPI:1962409193
Name:ZARATE, JORGE (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:ZARATE
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 1:3241 WESTERN BRANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5260
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:830 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-967-8622
Practice Address - Fax:757-686-0541
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056807174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA18854OtherSENTARA
7085020OtherAETNA
541910047OtherVA HEALTH NETWORK
NC89064GXMedicaid
CAXPY196491Medicaid
PA603296OtherBC/BS OF PENNSYLVANIA
541910047OtherFIRST HEALTH
FL911940000Medicaid
371626OtherMDIPA/MAMSI/OPTIMUM CHOIC
541910047OtherCIGNA
0007085020OtherAETNA US HEALTH
VA005607876Medicaid
GA300044765AMedicaid
VA381726OtherANTHEM BC/BS
VA005607876Medicaid
CAXPY196491Medicaid
G75678Medicare UPIN