Provider Demographics
NPI:1043308257
Name:ZEHRA S KAKA M.D. INC.
Entity Type:Organization
Organization Name:ZEHRA S KAKA M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-452-0274
Mailing Address - Street 1:1580 MUSSELMAN DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-9617
Mailing Address - Country:US
Mailing Address - Phone:740-452-0274
Mailing Address - Fax:740-452-0274
Practice Address - Street 1:800 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2882
Practice Address - Country:US
Practice Address - Phone:740-454-5014
Practice Address - Fax:740-455-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0937713Medicaid
OH0937713Medicaid