Provider Demographics
NPI:1912900408
Name:ZAKHOUR, ISAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAM
Middle Name:J
Last Name:ZAKHOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:367 W EVANS ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3429
Mailing Address - Country:US
Mailing Address - Phone:843-669-4156
Mailing Address - Fax:843-664-0962
Practice Address - Street 1:367 W EVANS ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3429
Practice Address - Country:US
Practice Address - Phone:843-669-4156
Practice Address - Fax:843-664-0962
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11168207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC180012102OtherRAILROAD MEDICARE
SC622365OtherSELECT HEALTH
NC7906985Medicaid
SC4255275OtherAETNA
SCS327575OtherCIGNA
SC9624212OtherGHI
SCAT1229Medicaid
SC276873OtherPRIVATE HEALTHCARE SYSTEM
SC9624212OtherGHI