Healthcare Provider Details
I. General information
NPI: 1699046466
Provider Name (Legal Business Name): ZEINAB I. EL BOGHDADLY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/25/2012
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1581 DODD DR
COLUMBUS OH
43210-1257
US
IV. Provider business mailing address
700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US
V. Phone/Fax
- Phone: 614-293-4854
- Fax: 614-293-8102
- Phone: 614-293-4854
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | 35128659 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: