Healthcare Provider Details

I. General information

NPI: 1629260062
Provider Name (Legal Business Name): SYED I.H. ZAIDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SYED I.H. ZAIDI MD

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20032-2601
US

IV. Provider business mailing address

3915 CHACO RD
ALEXANDRIA VA
22312-1029
US

V. Phone/Fax

Practice location:
  • Phone: 703-774-8243
  • Fax:
Mailing address:
  • Phone: 703-774-8243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberMD 16886
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 16886
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: