Provider Demographics
NPI:1649270828
Name:HAIDER, ZEHRA (MD)
Entity type:Individual
Prefix:
First Name:ZEHRA
Middle Name:
Last Name:HAIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3509 S REED RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3838
Practice Address - Country:US
Practice Address - Phone:765-453-8550
Practice Address - Fax:765-453-8049
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052732A207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00210404OtherRRCM
IN20015334CMedicaid
IN200318260Medicaid
INP01270951OtherRR MEDICARE
INP01824446OtherRR MEDICARE
IN248890AMedicare PIN
IN266180808Medicare PIN
ININ1663014Medicare PIN