Healthcare Provider Details

I. General information

NPI: 1023242583
Provider Name (Legal Business Name): HADI ZAHRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N 29TH ST SUITE 101
NORFOLK NE
68701-4424
US

IV. Provider business mailing address

PO BOX 641850
OMAHA NE
68164-7850
US

V. Phone/Fax

Practice location:
  • Phone: 402-644-7550
  • Fax: 402-644-7551
Mailing address:
  • Phone: 402-572-3535
  • Fax: 402-572-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number24514
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: