Provider Demographics
NPI:1447770631
Name:ZAKKA, FOUAD (MD)
Entity Type:Individual
Prefix:DR
First Name:FOUAD
Middle Name:
Last Name:ZAKKA
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 1:3300 BUCKEYE RD STE 178
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4232
Mailing Address - Country:US
Mailing Address - Phone:617-821-0008
Mailing Address - Fax:
Practice Address - Street 1:3300 BUCKEYE RD STE 178
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4232
Practice Address - Country:US
Practice Address - Phone:770-458-6101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP03968207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology