Healthcare Provider Details

I. General information

NPI: 1477990190
Provider Name (Legal Business Name): SEMAH ZAVAREH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

1111 E MCDOWELL RD
PHOENIX AZ
85006-2612
US

V. Phone/Fax

Practice location:
  • Phone: 602-839-2296
  • Fax: 602-839-2084
Mailing address:
  • Phone: 602-839-2296
  • Fax: 602-839-2084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number006928
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR2282
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOP61602956
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number96820
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: