MEDICARE: ZEIDAN FADEL ZEIDAN MD

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	208600000X	Surgery Physician	9501160	NC

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

General Provider Information

NPI Number	:	1508816778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZEIDAN FADEL ZEIDAN MD

Provider Business Mailing Address
First Line	:	921 LONG DR
Second Line	:	SUITE 206
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4874
Country	:	US
Telephone Number	:	910-417-3410
Fax Number	:	910-417-3420

Provider Business Practice Location Address
First Line	:	921 LONG DR
Second Line	:	SUITE 206
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4874
Country	:	US
Telephone Number	:	910-417-3410
Fax Number	:	910-417-3420

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	11/27/2012

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