Provider Demographics
NPI:1881631430
Name:ZANDO, IRAM KAREEMI (MD)
Entity type:Individual
Prefix:DR
First Name:IRAM
Middle Name:KAREEMI
Last Name:ZANDO
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:PO BOX 53134
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-3134
Mailing Address - Country:US
Mailing Address - Phone:318-797-0009
Mailing Address - Fax:318-797-0092
Practice Address - Street 1:1400 E BERT KOUNS LOOP
Practice Address - Street 2:SUITE 104
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5603
Practice Address - Country:US
Practice Address - Phone:318-797-0009
Practice Address - Fax:318-797-0092
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09509R207P00000X, 207RI0200X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1966525Medicaid
LA5R668DR93Medicare PIN
LA1966525Medicaid
LA5R668Medicare PIN