Healthcare Provider Details

I. General information

NPI: 1184821829
Provider Name (Legal Business Name): ABDALLAH E ZAMARIA MD AND BARBARA HENIKE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24001 GREATER MACK AVE SUITE C
SAINT CLAIR SHORES MI
48080-1471
US

IV. Provider business mailing address

24001 GREATER MACK AVE SUITE C
SAINT CLAIR SHORES MI
48080-1471
US

V. Phone/Fax

Practice location:
  • Phone: 586-772-3244
  • Fax: 586-772-8550
Mailing address:
  • Phone: 586-772-3244
  • Fax: 586-772-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberAZ034941
License Number StateMI

VIII. Authorized Official

Name: DR. ABDALLAH E ZAMARIA
Title or Position: OWNER
Credential: MD
Phone: 586-772-3244