Healthcare Provider Details

I. General information

NPI: 1043771165
Provider Name (Legal Business Name): MUSAB MEDENI ZORLU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MAIN ST
SPRINGFIELD MA
01107-1112
US

IV. Provider business mailing address

280 CHESTNUT ST FL 2
SPRINGFIELD MA
01199-1000
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-5600
  • Fax: 413-794-7297
Mailing address:
  • Phone: 413-794-5600
  • Fax: 413-794-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number1021498
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: