Provider Demographics
NPI:1215934856
Name:HEIDARI, ZAHRA (MD)
Entity type:Individual
Prefix:
First Name:ZAHRA
Middle Name:
Last Name:HEIDARI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 LEITER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3698
Mailing Address - Country:US
Mailing Address - Phone:937-866-0741
Mailing Address - Fax:937-866-8861
Practice Address - Street 1:2115 LEITER RD STE 100
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3698
Practice Address - Country:US
Practice Address - Phone:937-866-0741
Practice Address - Fax:937-866-8861
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH79820207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH015956OtherUNITED HEALTHCARE
ND080179067OtherRR MEDICARE
OHD79820OtherHUMANA CHOICE CARE
OH2278717Medicaid
OH7903612OtherAETNA
OH9264927002OtherCIGNA
OH000000207620OtherANTHEM
OH0361500001OtherMEDICAL DURABLE MED
OH7903612OtherAETNA
OHH42779Medicare UPIN