Healthcare Provider Details

I. General information

NPI: 1972555472
Provider Name (Legal Business Name): OSAMA O ZAIDAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CHERRY ST SUITE M200
TOLEDO OH
43608-2673
US

IV. Provider business mailing address

2200 JEFFERSON AVE
TOLEDO OH
43604-7101
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-8019
  • Fax: 419-251-5819
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number35.070657
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35070657
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: