Healthcare Provider Details

I. General information

NPI: 1710063292
Provider Name (Legal Business Name): ZAHID SAQIB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S PLUM
CARMI IL
62821
US

IV. Provider business mailing address

402 S PLUM
CARMI IL
62821
US

V. Phone/Fax

Practice location:
  • Phone: 618-384-2226
  • Fax: 618-382-5710
Mailing address:
  • Phone: 618-384-2226
  • Fax: 618-382-5710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036 05 8208
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: