Healthcare Provider Details

I. General information

NPI: 1366323446
Provider Name (Legal Business Name): ZEKERIYA SUAT OZDEN I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 10/24/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 REYES LN
MORGANTOWN WV
26508-2200
US

IV. Provider business mailing address

14 REYES LN
MORGANTOWN WV
26508-2200
US

V. Phone/Fax

Practice location:
  • Phone: 304-282-9810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME147984
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberME147984
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: