DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KHALEELUR R ZACKARIYA SR., MD

Active

DR. KHALEELUR R ZACKARIYA SR., MD is a Addiction Medicine (Internal Medicine) healthcare provider located in MISHIWAKA, Indiana. NPI 1306854203 is currently active in the NPPES registry. Verify at CMS.

Addiction Medicine (Internal Medicine) · MISHIWAKA, IN

Registration Details

NPI Number
1306854203
Provider Type
Individual
Gender
Male
NPI Issued
Aug 4, 2006 (20.063828085645 yrs)
Last Updated
Oct 30, 2024
Licenses
01066056A (IN)
01066056A (IN)
036098582 (IL)

Practice Information

Address
5215 HOLYCROSS PARKWAY
MISHIWAKA, IN, 46545
Browse IN providers · Browse ZIP 46545
Phone
5742377168
Fax
5744726262
Primary Specialty
Addiction Medicine (Internal Medicine)
207RA0401X
Additional Specialty
Internal Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.