Provider Demographics
NPI:1316507635
Name:ALAM, ZAINAB
Entity type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:ALAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZAINAB
Other - Middle Name:
Other - Last Name:ZAHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 CONCOURSE W
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6007
Mailing Address - Country:US
Mailing Address - Phone:207-873-1036
Mailing Address - Fax:
Practice Address - Street 1:16 CONCOURSE W
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6007
Practice Address - Country:US
Practice Address - Phone:207-873-1036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MEMD25345208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program