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1376002147 NPI number — GEORGE A ZAKHEM MD/MBA

NPI Number: 1376002147
Health Care Provider/Practitioner: GEORGE A ZAKHEM MD/MBA

Information about “1376002147” NPI (GEORGE A ZAKHEM MD/MBA) exists in 1376002147 in HTML format HTML  |  1376002147 in plain Text format TXT  |  1376002147 in PDF (Portable Document Format) PDF  |  1376002147 in an XML format XML  formats.

NPI Number : 1376002147 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376002147",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ZAKHEM",
    "FirstName": "GEORGE",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD/MBA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ZAKHEM",
    "OtherFirstName": "GEORGE",
    "OtherMiddleName": "ANDREW",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD/MBA",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "752 N HIGH POINT RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MADISON",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53717-2236",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "608-824-4000",
    "MailingAddressFaxNumber": "608-824-4949",
    "FirstLinePracticeLocationAddress": "752 N HIGH POINT RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MADISON",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53717-2236",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "608-824-4000",
    "PracticeLocationAddressFaxNumber": "608-824-4949",
    "EnumerationDate": "03/19/2019",
    "LastUpdateDate": "09/20/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207N00000X",
        "TaxonomyName": "Dermatology Physician",
        "LicenseNumber": "81894-20",
        "LicenseNumberStateCode": "WI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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