Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036147413 | GA |
N | 207Q00000X | Family Doctor | 036147413 | IL |
N | 207Q00000X | Family Doctor | 2017-01389 | NC |
N | 207Q00000X | Family Doctor | 219-320 | WI |
N | 207Q00000X | Family Doctor | 26309 | MS |
N | 207Q00000X | Family Doctor | 290033 | NY |
N | 207Q00000X | Family Doctor | 35.122879 | OH |
N | 207Q00000X | Family Doctor | 4301113244 | MI |
N | 207Q00000X | Family Doctor | 51568 | CT |
N | 207Q00000X | Family Doctor | 64766 | MN |
N | 207Q00000X | Family Doctor | 71067 | GA |
N | 207Q00000X | Family Doctor | MD.37729 | AL |
N | 207Q00000X | Family Doctor | MD450045 | PA |
N | 207Q00000X | Family Doctor | P9339 | TX |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 47802 | AZ |
NPI | 1740593797 |
---|---|
Provider Name | Dr. Zaid Fadul |
First Address | Mesa, AZ 85277-1506 |
Second Address | Gold Canyon, AZ 85118-2997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2010 |
Last Update Date | 16/09/2021 |