Individual
TAREQ Z.S. QDAISAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2018
(859) 301-2073
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-2018
(859) 301-2073
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01092443A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
32402
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
57980
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
TP529
KY
Other
Enumeration date
04/12/2015
Last updated
02/29/2024
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