Provider Demographics
NPI:1356341986
Name:TAHIR, SYED ZUBAIR (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:ZUBAIR
Last Name:TAHIR
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 1:4824 E BASELINE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4680
Mailing Address - Country:US
Mailing Address - Phone:480-854-8124
Mailing Address - Fax:
Practice Address - Street 1:4824 E BASELINE RD STE 140
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4680
Practice Address - Country:US
Practice Address - Phone:480-854-8124
Practice Address - Fax:480-854-8165
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19801208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ160482Medicaid
AZZ78225Medicare PIN