=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689014730
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ENAS AL ZAGHAL M.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2013
-----------------------------------------------------
Last Update Date | 07/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3901 W NORFOLK AVE STE R
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68701-9501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-844-8110
-----------------------------------------------------
Fax | 402-379-2349
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1104 W 8TH ST
-----------------------------------------------------
City | YANKTON
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57078-3306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-665-7841
-----------------------------------------------------
Fax | 605-665-8337
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | 17483
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | 30992
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------