Healthcare Provider Details

I. General information

NPI: 1316507635
Provider Name (Legal Business Name): ZAINAB ALAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZAINAB ZAHUR

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 FAIRVIEW AVE STE 225
SKOWHEGAN ME
04976-1481
US

IV. Provider business mailing address

PO BOX 468
SKOWHEGAN ME
04976-0468
US

V. Phone/Fax

Practice location:
  • Phone: 207-474-6265
  • Fax: 207-474-8365
Mailing address:
  • Phone: 207-858-8367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD25345
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: