Basic Information
| Provider Information | |||||||||
| NPI: | 1598724049 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VIRK | ||||||||
| FirstName: | ZAHID | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 S DOBSON RD | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852024707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805432034 | ||||||||
| FaxNumber: | 4804126089 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 S DOBSON RD | ||||||||
| Address2: | 2004-2F | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852024707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804126083 | ||||||||
| FaxNumber: | 4804126089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2006 | ||||||||
| LastUpdateDate: | 10/08/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 36009 | AZ | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 36009 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207R00000X | 36009 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02671685 | 05 | NY | MEDICAID |