Healthcare Provider Details

I. General information

NPI: 1841227956
Provider Name (Legal Business Name): ZOHER N VASI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9742 US HIGHWAY 127
SHERWOOD OH
43556-9739
US

IV. Provider business mailing address

3926 NEW VISION DR
FORT WAYNE IN
46845-1712
US

V. Phone/Fax

Practice location:
  • Phone: 419-899-2137
  • Fax: 419-899-2138
Mailing address:
  • Phone: 260-266-8211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35045059
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: