Provider Demographics
NPI:1679599625
Name:ZAKI, BASSEM ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSEM
Middle Name:ISAAC
Last Name:ZAKI
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 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC RADIATION ONCOLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-6600
Mailing Address - Fax:603-650-6616
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC RADIATION ONCOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-6600
Practice Address - Fax:603-650-6616
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH112592085R0001X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30202049Medicaid
VT1008587Medicaid
NH30202049Medicaid
VTVN306601Medicare PIN
H56072Medicare UPIN