Healthcare Provider Details

I. General information

NPI: 1194773952
Provider Name (Legal Business Name): HASAN A ZIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW SIBLEY MEMORIAL HOSPITAL
WASHINGTON DC
20016-2633
US

IV. Provider business mailing address

5255 LOUGHBORO RD NW SIBLEY MEMORIAL HOSPITAL
WASHINGTON DC
20016-2633
US

V. Phone/Fax

Practice location:
  • Phone: 202-747-4827
  • Fax: 202-537-4290
Mailing address:
  • Phone: 202-747-4827
  • Fax: 202-537-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberD0060156
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: