Provider Demographics
NPI:1861509465
Name:HAIDAR-AHMAD, ZAHI (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAHI
Middle Name:
Last Name:HAIDAR-AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ZAHI
Other - Middle Name:
Other - Last Name:HAIDAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MSBA
Mailing Address - Street 1:300 W CLARENDON AVE STE 375
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3476
Mailing Address - Country:US
Mailing Address - Phone:315-382-1755
Mailing Address - Fax:602-266-3481
Practice Address - Street 1:300 W CLARENDON AVE STE 375
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3476
Practice Address - Country:US
Practice Address - Phone:315-382-1755
Practice Address - Fax:602-266-3481
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ365102080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ36510OtherAZ MD LICENSE