Healthcare Provider Details

I. General information

NPI: 1558314864
Provider Name (Legal Business Name): EMAD M. ZAKHARY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 S SPRING AVE
SAINT LOUIS MO
63110-2520
US

IV. Provider business mailing address

SLU ACADEMIC PAVILION 1008 SOUTH SPRING AVE.
ST. LOUIS MO
63110-3034
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6369
  • Fax:
Mailing address:
  • Phone: 314-977-4440
  • Fax: 314-977-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2010032316
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD422072
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: