Healthcare Provider Details

I. General information

NPI: 1285157917
Provider Name (Legal Business Name): MHD SAID AL ZEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E 2ND ST STE E
COUDERSPORT PA
16915-8161
US

IV. Provider business mailing address

1001 E 2ND ST
COUDERSPORT PA
16915-8161
US

V. Phone/Fax

Practice location:
  • Phone: 814-260-5576
  • Fax: 814-260-5551
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD467046
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: