Provider Demographics
NPI:1124293790
Name:Z. A. DALU M.D.,INC
Entity type:Organization
Organization Name:Z. A. DALU M.D.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:ZIAD
Authorized Official - Last Name:ABUDALU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-647-5754
Mailing Address - Street 1:6744 CLAYTON RD STE 305
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1639
Mailing Address - Country:US
Mailing Address - Phone:314-647-5754
Mailing Address - Fax:314-647-1297
Practice Address - Street 1:6744 CLAYTON RD STE 305
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1639
Practice Address - Country:US
Practice Address - Phone:314-647-5754
Practice Address - Fax:314-647-1297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6714261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care