Provider Demographics
NPI:1437266145
Name:SHABAZZ, ZAKEE OMAR (DPM)
Entity Type:Individual
Prefix:DR
First Name:ZAKEE
Middle Name:OMAR
Last Name:SHABAZZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12011 LEE JACKSON MEMORIAL HWY STE 440
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3335
Mailing Address - Country:US
Mailing Address - Phone:703-865-6783
Mailing Address - Fax:703-865-6784
Practice Address - Street 1:12011 LEE JACKSON MEMORIAL HWY STE 440
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3335
Practice Address - Country:US
Practice Address - Phone:703-865-6783
Practice Address - Fax:703-865-6784
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO1000050213ES0103X
MD01438213ES0103X
CAE4544213ES0103X
VA0103300961213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00407085OtherRAILROAD MEDICARE
CAV00600Medicare UPIN
VA159262Medicare UPIN
DC020752N56Medicare PIN