Provider Demographics
NPI:1285946566
Name:ZAGHLOUL, HAZIM (MD)
Entity type:Individual
Prefix:
First Name:HAZIM
Middle Name:
Last Name:ZAGHLOUL
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:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-5454
Mailing Address - Fax:515-643-5460
Practice Address - Street 1:330 LAUREL ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3034
Practice Address - Country:US
Practice Address - Phone:515-643-5454
Practice Address - Fax:515-643-5460
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-437122080P0206X
MI43010897002080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology