Healthcare Provider Details

I. General information

NPI: 1275465064
Provider Name (Legal Business Name): ZEINAB BEYDOUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5703 ROUGE CT
DEARBORN HTS MI
48127-2712
US

IV. Provider business mailing address

5703 ROUGE CT
DEARBORN HTS MI
48127-2712
US

V. Phone/Fax

Practice location:
  • Phone: 313-289-2303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704411861
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: