Provider Demographics
NPI:1841227956
Name:VASI, ZOHER N (MD)
Entity Type:Individual
Prefix:
First Name:ZOHER
Middle Name:N
Last Name:VASI
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 1:3926 NEW VISION DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1712
Mailing Address - Country:US
Mailing Address - Phone:260-266-8211
Mailing Address - Fax:
Practice Address - Street 1:9742 US HIGHWAY 127
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OH
Practice Address - Zip Code:43556-9739
Practice Address - Country:US
Practice Address - Phone:419-899-2137
Practice Address - Fax:419-899-2138
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045059208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00082512OtherRAILROAD
OH0469952Medicaid
OH0502416Medicare PIN
OHP00082512OtherRAILROAD