Provider Demographics
NPI:1649330879
Name:RAZEK, ZACK A (MD)
Entity type:Individual
Prefix:
First Name:ZACK
Middle Name:A
Last Name:RAZEK
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 1:9313 E 34TH ST N
Mailing Address - Street 2:STE 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2637
Mailing Address - Country:US
Mailing Address - Phone:316-685-6091
Mailing Address - Fax:
Practice Address - Street 1:9300 E 29TH ST N
Practice Address - Street 2:STE 208
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2182
Practice Address - Country:US
Practice Address - Phone:316-685-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17167207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease