MEDICARE: LARAMIC MEDICAL GROUP, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083B0002X	Obesity Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1063389401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARAMIC MEDICAL GROUP, P.A.

Provider Business Mailing Address
First Line	:	2858 UNIVERSITY AVE STE 253
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-3644
Country	:	US
Telephone Number	:	518-290-7091
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 OAK RIDGE BLVD
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-9715
Country	:	US
Telephone Number	:	518-290-7091
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ZAID FADUL
Credential	:	MD
Telephone Number	:	408-490-6656

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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