Healthcare Provider Details

I. General information

NPI: 1346471794
Provider Name (Legal Business Name): ZICHERMAN AND ZICHERMAN D.P.M., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2009
Last Update Date: 08/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18663 LIVERNOIS AVE
DETROIT MI
48221-4212
US

IV. Provider business mailing address

18663 LIVERNOIS AVE
DETROIT MI
48221-4212
US

V. Phone/Fax

Practice location:
  • Phone: 313-341-0953
  • Fax: 313-341-0308
Mailing address:
  • Phone: 313-341-0953
  • Fax: 313-234-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. HERMAN ZICHERMAN
Title or Position: V.P.
Credential: D.P.M.
Phone: 313-341-0953