Provider Demographics
NPI:1760652648
Name:ALSOUFI, ZIAD M (MD)
Entity Type:Individual
Prefix:
First Name:ZIAD
Middle Name:M
Last Name:ALSOUFI
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 1:12040 NE 128TH ST
Mailing Address - Street 2:MS 11
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-899-5359
Mailing Address - Fax:425-899-3143
Practice Address - Street 1:12040 NE 128TH ST
Practice Address - Street 2:MS 11
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3013
Practice Address - Country:US
Practice Address - Phone:425-899-5359
Practice Address - Fax:425-899-3143
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01067754A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200991350Medicaid
INM400022777Medicare PIN