Provider Demographics
NPI:1538112388
Name:ZAKAIB, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:ZAKAIB
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 1:7373 FRANCE AVE S STE 300
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4538
Mailing Address - Country:US
Mailing Address - Phone:952-428-0500
Mailing Address - Fax:952-428-0589
Practice Address - Street 1:7373 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4534
Practice Address - Country:US
Practice Address - Phone:855-644-4787
Practice Address - Fax:952-428-0589
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231846207RC0001X
VA0101230846207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA353042OtherSOUTHERN HEALTH
VAC10061OtherMEDICARE GROUP PIN
VA1538112388Medicaid
VAP00619622OtherRR MEDICARE PIN
VA353042OtherANTHEM
VAH64570Medicare UPIN
VA1538112388Medicaid
VA353042OtherSOUTHERN HEALTH