Provider Demographics
NPI:1033102975
Name:ZAKI, WAFIK I (MD)
Entity Type:Individual
Prefix:
First Name:WAFIK
Middle Name:I
Last Name:ZAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:920 ELKRIDGE LANDING RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2917
Mailing Address - Country:US
Mailing Address - Phone:443-462-5010
Mailing Address - Fax:410-684-2031
Practice Address - Street 1:836 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1398
Practice Address - Country:US
Practice Address - Phone:410-479-5900
Practice Address - Fax:410-479-5901
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD242511400Medicaid
G05500Medicare UPIN