Provider Demographics
NPI:1558333815
Name:UDDIN, ZIA U (MD)
Entity Type:Individual
Prefix:MR
First Name:ZIA
Middle Name:U
Last Name:UDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ZIA
Other - Middle Name:U
Other - Last Name:UDDIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:251 EAST ANTIETAM STREET
Mailing Address - Street 2:NEONATOLOGY WASHINGTON COUNTY HOSPITAL
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4070
Mailing Address - Country:US
Mailing Address - Phone:301-790-8421
Mailing Address - Fax:301-790-9121
Practice Address - Street 1:251 EAST ANTIETAM STREET
Practice Address - Street 2:SPECIAL CARE NURSERY WASHINGTON COUNTY HOSPITAL
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4070
Practice Address - Country:US
Practice Address - Phone:301-790-8421
Practice Address - Fax:301-790-9121
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36839208000000X
MDD00644552080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6405604700Medicaid
KY0253436Medicare ID - Type Unspecified
KY6405604700Medicaid