Provider Demographics
NPI:1003818493
Name:ZAFAR, FAWAD SABOOH (MD)
Entity Type:Individual
Prefix:
First Name:FAWAD
Middle Name:SABOOH
Last Name:ZAFAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 73RD ST STE 17
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1321
Mailing Address - Country:US
Mailing Address - Phone:515-277-8900
Mailing Address - Fax:515-223-7361
Practice Address - Street 1:1000 73RD ST STE 17
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-1321
Practice Address - Country:US
Practice Address - Phone:515-277-8900
Practice Address - Fax:515-223-7361
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30827208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1649223835Medicaid
IA340014274OtherRAILROAD MEDICARE
IA1649223835OtherWELLMARK BCBS
IA1649223835Medicaid