Provider Demographics
NPI:1548477169
Name:ZIAD L. ZAWAIDEH M.D.
Entity type:Organization
Organization Name:ZIAD L. ZAWAIDEH M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZAWAIDEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-558-2500
Mailing Address - Street 1:4951 CENTER ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3251
Mailing Address - Country:US
Mailing Address - Phone:402-558-2500
Mailing Address - Fax:402-558-5522
Practice Address - Street 1:4951 CENTER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3251
Practice Address - Country:US
Practice Address - Phone:402-558-2500
Practice Address - Fax:402-558-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE4735OtherMIDLANDS CHOICE ASSIGNED
IA0912196OtherIOWA MEDICAID PROVIDER #
NE0100013OtherUHC PROVIDER #
NE5028044OtherAETNA PROVIDER #
IA920579OtherWELLMARK BCBS
NE00966OtherBLUECROSS ASSIGNED NUMBER
NE143144500OtherACS OWCP
NE5028044OtherAETNA PROVIDER #
NED05173Medicare UPIN
NE010018251Medicare ID - Type UnspecifiedRAILROAD MEDICARE #
NE088735Medicare ID - Type UnspecifiedPROVIDER NUMBER