Healthcare Provider Details

I. General information

NPI: 1710952924
Provider Name (Legal Business Name): LYNN Y ZOIOPOULOS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7430 2ND AVE SUITE 210
DETROIT MI
48202-2739
US

IV. Provider business mailing address

43166 LOCHRISEN WAY APT 3308
NOVI MI
48375-5410
US

V. Phone/Fax

Practice location:
  • Phone: 313-748-4200
  • Fax: 313-748-4187
Mailing address:
  • Phone: 312-259-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036082082
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101008976
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: