Basic Information
| Provider Information | |||||||||
| NPI: | 1982137626 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ZIA | ||||||||
| FirstName: | MARYAM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 FORBES AVE | ||||||||
| Address2: | FORBES TOWER PLAZA SUITE 140 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126476340 | ||||||||
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| Practice Location | |||||||||
| Address1: | 105 PONCER COURT | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | DANVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592364852 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2017 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 56929 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.