MEDICARE: AHMAD F ZEGAR MD

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	207R00000X	Internal Medicine Physician	01042256	IN

General Provider Information

NPI Number	:	1902891328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD F ZEGAR MD

Provider Business Mailing Address
First Line	:	238 E 90TH DR
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-8102
Country	:	US
Telephone Number	:	219-736-6870
Fax Number	:	219-738-6714

Provider Business Practice Location Address
First Line	:	8701 BROADWAY
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-7035
Country	:	US
Telephone Number	:	219-738-5510
Fax Number	:	219-738-6714

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	04/01/2008

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