Provider Demographics
NPI:1073520128
Name:ZIADA, KHALED M (MD)
Entity Type:Individual
Prefix:
First Name:KHALED
Middle Name:M
Last Name:ZIADA
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 1:9500 EUCLID AVENUE
Mailing Address - Street 2:DESK J2-3
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0200
Mailing Address - Country:US
Mailing Address - Phone:216-444-0926
Mailing Address - Fax:216-636-6960
Practice Address - Street 1:9500 EUCLID AVENUE
Practice Address - Street 2:DESK J2-3
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-444-0926
Practice Address - Fax:216-636-6960
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38725207R00000X, 207RC0000X, 207RI0011X
OH82065207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64088933Medicaid
KY64088933Medicaid
KY929141Medicare PIN