Provider Demographics
NPI:1427115179
Name:ZOHARY, HOSSAM ALI (MD)
Entity type:Individual
Prefix:DR
First Name:HOSSAM
Middle Name:ALI
Last Name:ZOHARY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5901-C PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:678-441-8500
Mailing Address - Fax:678-441-8619
Practice Address - Street 1:1 SAINT JOSEPH DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3742
Practice Address - Country:US
Practice Address - Phone:859-313-2963
Practice Address - Fax:859-313-3541
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2015-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY44321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0069258Medicaid
MT0069258Medicaid
MT000008363Medicare ID - Type Unspecified