MEDICARE: DR. MUHAMMAD ZIAD SOUQIYYEH M.D.

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	207RN0300X	Nephrology Physician	4301109974	MI
2	207RN0300X	Nephrology Physician	01080186A	IN
3	207RN0300X	Nephrology Physician	E-16356	AR

General Provider Information

NPI Number	:	1538612015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUHAMMAD ZIAD SOUQIYYEH M.D.

Provider Business Mailing Address
First Line	:	7303 ROGERS AVE STE 200
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4112
Country	:	US
Telephone Number	:	479-274-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	7303 ROGERS AVE STE 200
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4112
Country	:	US
Telephone Number	:	479-274-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2016
Last Update Date	:	04/04/2023

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