Healthcare Provider Details

I. General information

NPI: 1679647200
Provider Name (Legal Business Name): ROBERT RAJA ZAID D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39555 W 10 MILE RD STE 302
NOVI MI
48375-2950
US

IV. Provider business mailing address

39555 W 10 MILE RD STE 302
NOVI MI
48375-2950
US

V. Phone/Fax

Practice location:
  • Phone: 248-426-7200
  • Fax: 248-426-7335
Mailing address:
  • Phone: 248-426-7200
  • Fax: 248-426-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101016340
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: