Healthcare Provider Details

I. General information

NPI: 1669988002
Provider Name (Legal Business Name): MATTHEW A ZIEGLER MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 12/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 CROOKS RD
ROYAL OAK MI
48067-1301
US

IV. Provider business mailing address

1121 CROOKS RD
ROYAL OAK MI
48067-1301
US

V. Phone/Fax

Practice location:
  • Phone: 248-541-7023
  • Fax: 248-541-3563
Mailing address:
  • Phone: 248-541-7023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number4301096616
License Number StateMI

VIII. Authorized Official

Name: MATTHEW A ZIEGLER
Title or Position: OWNER
Credential: MD
Phone: 248-541-7023