Healthcare Provider Details

I. General information

NPI: 1417336421
Provider Name (Legal Business Name): MICHAEL D ZERAFA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 10/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 N FENWAY DR
FENTON MI
48430-2666
US

IV. Provider business mailing address

3495 S CENTER RD
BURTON MI
48519-1455
US

V. Phone/Fax

Practice location:
  • Phone: 810-750-6050
  • Fax: 810-750-6081
Mailing address:
  • Phone: 810-424-2011
  • Fax: 810-249-4037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301101651
License Number StateMI

VIII. Authorized Official

Name: MICHAEL ZERAFA
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 810-750-6050