Healthcare Provider Details

I. General information

NPI: 1235579574
Provider Name (Legal Business Name): ZIV TSAFRIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2013
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

7632 GOSHEN DR
WEST BLOOMFIELD MI
48322-5003
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-1601
  • Fax: 313-916-8843
Mailing address:
  • Phone: 248-826-3782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4301103846
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: