Provider Demographics
NPI:1790724185
Name:ZEHRI, WAHEED H (MD)
Entity Type:Individual
Prefix:
First Name:WAHEED
Middle Name:H
Last Name:ZEHRI
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 1:1225 E. HANCOCK ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-5961
Mailing Address - Country:US
Mailing Address - Phone:928-758-0145
Mailing Address - Fax:928-758-0145
Practice Address - Street 1:1225 HANCOCK RD
Practice Address - Street 2:#C
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442
Practice Address - Country:US
Practice Address - Phone:928-758-0121
Practice Address - Fax:928-758-0128
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23454207R00000X
NV8165207R00000X
CAA60180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ323296Medicaid
AZAZ0881610OtherBLUE CROSS
AZAZ0881610OtherBLUE CROSS
AZ323296Medicaid