Healthcare Provider Details

I. General information

NPI: 1992709406
Provider Name (Legal Business Name): IRA ZALTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30575 WOODWARD AVE
ROYAL OAK MI
48073-0980
US

IV. Provider business mailing address

26211 CENTRAL PARK BLVD STE 201
SOUTHFIELD MI
48076-4158
US

V. Phone/Fax

Practice location:
  • Phone: 248-280-8550
  • Fax: 844-266-0093
Mailing address:
  • Phone: 833-667-3627
  • Fax: 833-972-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301075486
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: