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NPI Code Detail

MEDICARE: DR. MEDHAT YOUSSEF ZAKHER FANOUS M.D.

MEDICARE: DR. MEDHAT YOUSSEF ZAKHER FANOUS 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
1208600000XSurgery Physician4301091790MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134394661
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEDHAT YOUSSEF ZAKHER FANOUS M.D.
Provider Business Mailing Address
First Line : 1400 W ICE LAKE RD
Second Line :
City : IRON RIVER
State : MI
Zip : 49935-9526
Country : US
Telephone Number : 906-265-6121
Fax Number :
Provider Business Practice Location Address
First Line : 1500 W ICE LAKE RD
Second Line :
City : IRON RIVER
State : MI
Zip : 49935-8509
Country : US
Telephone Number : 906-265-9001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2008
Last Update Date : 06/04/2015

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