Provider Demographics
NPI:1639346083
Name:RZOUQ, FADI S (MBBS)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:S
Last Name:RZOUQ
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:109 N 29TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3251
Mailing Address - Country:US
Mailing Address - Phone:402-844-8287
Mailing Address - Fax:402-844-8288
Practice Address - Street 1:109 N 29TH ST
Practice Address - Street 2:STE 1
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3251
Practice Address - Country:US
Practice Address - Phone:402-844-8287
Practice Address - Fax:402-844-8288
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2017-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE28177207RG0100X
TXBP1-0028955207R00000X
KS04-34831207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine