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General NPI Number Information
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NPI Number | 1295705630
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Entity Type | Individual
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Provider Name | KHADIJEH S. ZARKOOB M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 504 6TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-2439
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Country | US
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Telephone | 208-799-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 11919 PARK HEIGHTS AVE
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City | OWINGS MILLS
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State | MD
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Zip | 21117
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Country | US
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Telephone | 410-303-9111
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Fax | 410-356-4980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | DOO63905
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 51193
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MC-0720
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 35C.000242
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License Number State | OH
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