Healthcare Provider Details

I. General information

NPI: 1558443929
Provider Name (Legal Business Name): LOGHMAN ZAIIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 POPLARWOOD CT STE 300
RALEIGH NC
27604-6445
US

IV. Provider business mailing address

1021 GROGANS MILL DR
CARY NC
27519-7193
US

V. Phone/Fax

Practice location:
  • Phone: 919-931-4331
  • Fax:
Mailing address:
  • Phone: 919-931-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33327
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number33327
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: