Healthcare Provider Details

I. General information

NPI: 1568653780
Provider Name (Legal Business Name): WOMEN'S HEALTHCARE ASSOCIATES OF OAKLAND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 S LAPEER RD
LAKE ORION MI
48360-1437
US

IV. Provider business mailing address

PO BOX 2137
BIRMINGHAM MI
48012-2137
US

V. Phone/Fax

Practice location:
  • Phone: 248-693-0543
  • Fax: 248-693-3683
Mailing address:
  • Phone: 248-872-1200
  • Fax: 248-494-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberJZ069018
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN THOMAS ZAIDAN
Title or Position: CEO
Credential: M.D.
Phone: 248-872-7786