Provider Demographics
NPI:1558314864
Name:ZAKHARY, EMAD M (MD)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:M
Last Name:ZAKHARY
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:SLU ACADEMIC PAVILION
Mailing Address - Street 2:1008 SOUTH SPRING AVE.
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-3034
Mailing Address - Country:US
Mailing Address - Phone:314-977-4440
Mailing Address - Fax:314-977-1642
Practice Address - Street 1:1008 S SPRING AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2520
Practice Address - Country:US
Practice Address - Phone:570-271-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4220722086S0129X
MO20100323162086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100835334Medicaid
H95701Medicare UPIN