Provider Demographics
NPI:1295707164
Name:ZAGLAMA, NABIL EDWARD (MD)
Entity type:Individual
Prefix:
First Name:NABIL
Middle Name:EDWARD
Last Name:ZAGLAMA
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 1:309 CRAFT MOORE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-9512
Mailing Address - Country:US
Mailing Address - Phone:724-785-2515
Mailing Address - Fax:724-785-2515
Practice Address - Street 1:1163 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1013
Practice Address - Country:US
Practice Address - Phone:724-258-1999
Practice Address - Fax:724-258-1814
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031199E174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000963832-0007Medicaid
PA25098OtherHEALTH AMERICA/ASSURANCE
PW095850OtherHIGH MARK BLUE SHIELD
PA61256OtherUNISON
PA095850Medicare ID - Type Unspecified
PAB36235Medicare UPIN