Provider Demographics
NPI:1144239443
Name:ZAKY, MAGED M (MD, FACP)
Entity Type:Individual
Prefix:
First Name:MAGED
Middle Name:M
Last Name:ZAKY
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 NINTH AVE.
Mailing Address - Street 2:1414
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602
Mailing Address - Country:US
Mailing Address - Phone:814-946-1655
Mailing Address - Fax:814-949-7616
Practice Address - Street 1:1414 9TH AVE.
Practice Address - Street 2:1414
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-946-1655
Practice Address - Fax:814-949-7616
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044191207R00000X
PAMD434892207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2063501OtherHIGHMARK
PA10219919100001Medicaid
PA2063501OtherHIGHMARK
PA10219919100001Medicaid