Healthcare Provider Details
I. General information
NPI: 1942736822
Provider Name (Legal Business Name): MOHAMED AHMED ZAAZOUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/11/2017
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 HIGHLAND AVE
MADISON WI
53792-1032
US
IV. Provider business mailing address
7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US
V. Phone/Fax
- Phone: 608-915-0900
- Fax: 608-662-3054
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | 2024016280 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | 85051 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: