Healthcare Provider Details

I. General information

NPI: 1982103362
Provider Name (Legal Business Name): PRIMECARE ON WIXOM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27250 WIXOM RD STE A
NOVI MI
48374-1116
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT ZAID
Title or Position: OWNER
Credential: DO
Phone: 248-426-7200