Healthcare Provider Details

I. General information

NPI: 1447291893
Provider Name (Legal Business Name): SAMMY A ZAKHARY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 06/20/2023
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6591 W THUNDERBIRD RD STE D1
GLENDALE AZ
85306-3720
US

IV. Provider business mailing address

6591 W THUNDERBIRD RD STE D1
GLENDALE AZ
85306-3720
US

V. Phone/Fax

Practice location:
  • Phone: 623-258-3255
  • Fax: 623-478-2215
Mailing address:
  • Phone: 623-258-3255
  • Fax: 623-478-2215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberM5988
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD422860
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number40583
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: