Provider Demographics
NPI:1649223835
Name:FAWAD S. ZAFAR MD PC
Entity Type:Organization
Organization Name:FAWAD S. ZAFAR MD PC
Other - Org Name:LAKEVIEW CENTER FOR UROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C E O
Authorized Official - Prefix:
Authorized Official - First Name:FAWAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZAFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-277-8900
Mailing Address - Street 1:1000 73RD ST STE 17
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1321
Mailing Address - Country:US
Mailing Address - Phone:515-277-8900
Mailing Address - Fax:515-223-7361
Practice Address - Street 1:1000 73RD ST STE 17
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-1321
Practice Address - Country:US
Practice Address - Phone:515-277-8900
Practice Address - Fax:515-223-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA207R00000X
208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IADD5681OtherRAILROAD MEDICARE
IA0454561Medicaid
IADD5681OtherRAILROAD MEDICARE
IAG23415Medicare UPIN