Healthcare Provider Details

I. General information

NPI: 1396911905
Provider Name (Legal Business Name): ZAKIYA N LOCKHART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2008
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7490 NEW TECHNOLOGY WAY
FREDERICK MD
21703
US

IV. Provider business mailing address

7490 NEW TECHNOLOGY WAY ANESTHESIOLOGY, S8A
FREDERICK MD
21703-8370
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-1639
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD72392
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: