Provider Demographics
NPI:1679557599
Name:KAUKAB, ZAHIDA PARVEEN (MD)
Entity Type:Individual
Prefix:
First Name:ZAHIDA
Middle Name:PARVEEN
Last Name:KAUKAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ZAHIDA
Other - Middle Name:PARVEEN
Other - Last Name:CHAUDHRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:441 VINE ST
Mailing Address - Street 2:#1038
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-2806
Mailing Address - Country:US
Mailing Address - Phone:513-621-3360
Mailing Address - Fax:513-621-6237
Practice Address - Street 1:441 VINE ST
Practice Address - Street 2:#1038
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2806
Practice Address - Country:US
Practice Address - Phone:513-621-3360
Practice Address - Fax:513-621-6237
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041903207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0366732Medicaid
A79203Medicare UPIN
OH0366732Medicaid