Provider Demographics
NPI:1588681365
Name:UMRUDDIN, ZIA MOHAMED (MD)
Entity type:Individual
Prefix:DR
First Name:ZIA
Middle Name:MOHAMED
Last Name:UMRUDDIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 E LANCASTER AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3453
Mailing Address - Country:US
Mailing Address - Phone:610-649-1175
Mailing Address - Fax:610-896-8753
Practice Address - Street 1:2223 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3215
Practice Address - Country:US
Practice Address - Phone:610-649-1175
Practice Address - Fax:484-300-4682
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2022-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD429598207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101693707Medicaid