Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 01066334A | IN |
Y | 2080P0210X | Pediatric Nephrologist | 01066334A | IN |
NPI | 1992864136 |
---|---|
Provider Name | Mona A Zawaideh |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-2052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 17/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200932850 | (05) | IN |
944612 | (05) | AZ |
I34785 | (02) |