Provider Demographics
NPI:1487600458
Name:ZAKI, KAREEM A (MD)
Entity type:Individual
Prefix:
First Name:KAREEM
Middle Name:A
Last Name:ZAKI
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 1:105 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2277
Mailing Address - Country:US
Mailing Address - Phone:276-236-5187
Mailing Address - Fax:276-236-3015
Practice Address - Street 1:105 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2277
Practice Address - Country:US
Practice Address - Phone:276-236-5187
Practice Address - Fax:276-236-3015
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053692208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010188491Medicaid
NC5902112Medicaid
VAP00265943OtherMEDICARE RAILROAD
VAP00265943OtherMEDICARE RAILROAD
VA5503130001Medicare NSC
VAG93722Medicare UPIN
VA010188491Medicaid