Basic Information
| Provider Information | |||||||||
| NPI: | 1659948297 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAJID | ||||||||
| FirstName: | ZARGHOONA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 141 N MANASSAS ST APT 10G | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381054561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054093252 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1101 W UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483071863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486014805 | ||||||||
| FaxNumber: | 2486014908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2021 | ||||||||
| LastUpdateDate: | 06/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 5315226261 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | 4351048569 | MI | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.