Provider Demographics
NPI:1225008915
Name:MIRZA, ZIAD KHALIL (MD)
Entity Type:Individual
Prefix:
First Name:ZIAD
Middle Name:KHALIL
Last Name:MIRZA
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 1:7600 OSLER DR STE 406
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7703
Mailing Address - Country:US
Mailing Address - Phone:410-821-8444
Mailing Address - Fax:410-821-8447
Practice Address - Street 1:7600 OSLER DR STE 406
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7703
Practice Address - Country:US
Practice Address - Phone:410-821-8444
Practice Address - Fax:410-821-8447
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD299511500Medicaid
MDF45776Medicare UPIN
MDF45776Medicare UPIN