Provider Demographics
NPI:1114189305
Name:ELMAADAWI, AHMED ZAKRIA YOUSSEF (MD,)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:ZAKRIA YOUSSEF
Last Name:ELMAADAWI
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 1:11154 E CANNON DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4850
Mailing Address - Country:US
Mailing Address - Phone:502-457-0711
Mailing Address - Fax:
Practice Address - Street 1:1111 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:602-839-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072115A2084P0804X, 2084P0800X
AZ729802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201162900Medicaid
IN201162900Medicaid
IN201162900Medicaid
IN000000815143OtherBCBS SOUTH BEND
MNENROLLEDMedicaid
IN000000932975OtherBCBS BMG ELKHART
IN236040132Medicare PIN