Healthcare Provider Details

I. General information

NPI: 1396867461
Provider Name (Legal Business Name): FAHD AZIZ ZARROUF M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST STE 1000
ANDERSON SC
29621-1714
US

IV. Provider business mailing address

109 ESSEX DR
ANDERSON SC
29621-3318
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-4935
  • Fax: 864-512-4932
Mailing address:
  • Phone: 864-512-4935
  • Fax: 864-512-4932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number31551
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31551
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number31551
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number31551
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: