Healthcare Provider Details

I. General information

NPI: 1871628255
Provider Name (Legal Business Name): ZICHERMAN & ZICHERMAN DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 01/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20526 PLYMOUTH RD
DETROIT MI
48228
US

IV. Provider business mailing address

20526 PLYMOUTH RD
DETROIT MI
48228
US

V. Phone/Fax

Practice location:
  • Phone: 313-273-3780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. HERMAN ZICHERMAN
Title or Position: VP
Credential: DPM
Phone: 313-273-3780