Individual
THEODORE DANIEL ZAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13995 W STATLER BLVD STE 150, SURPRISE, AZ 85374-5512
(480) 556-0446
Mailing address
13995 W STATLER BLVD STE 150, SURPRISE, AZ 85374-5512
(480) 556-0446
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
68724
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
68724
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
10/20/2023
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