Provider Demographics
NPI:1639123409
Name:ZUBERI, MUSSARET (MD)
Entity Type:Individual
Prefix:DR
First Name:MUSSARET
Middle Name:
Last Name:ZUBERI
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 1:32119 WILLOW CIR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2133
Mailing Address - Country:US
Mailing Address - Phone:440-930-2077
Mailing Address - Fax:440-988-6661
Practice Address - Street 1:630 E RIVER ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5902
Practice Address - Country:US
Practice Address - Phone:440-329-7450
Practice Address - Fax:440-329-7646
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94632207P00000X
OH35.063506207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0887643Medicaid
OH000000595762OtherANTHEM
OH0887643Medicaid
OH4254401Medicare PIN
OHZU4254402Medicare PIN
4132436Medicare PIN
F42699Medicare UPIN