Provider Demographics
NPI:1609877935
Name:ZYADEH, NADIM T (MD)
Entity type:Individual
Prefix:
First Name:NADIM
Middle Name:T
Last Name:ZYADEH
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:PO BOX 27340
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85061-7340
Mailing Address - Country:US
Mailing Address - Phone:602-943-9200
Mailing Address - Fax:602-216-3026
Practice Address - Street 1:2236 W BETHANY HOME RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1934
Practice Address - Country:US
Practice Address - Phone:602-943-6666
Practice Address - Fax:602-242-9220
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30881207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZA7998438OtherAETNA
AZAZ0734070OtherBLUE CROSS BLUE SHIELD
AZ776304Medicaid
AZZ118618Medicare PIN
AZAZ0734070OtherBLUE CROSS BLUE SHIELD
AZ776304Medicaid