Healthcare Provider Details

I. General information

NPI: 1326637331
Provider Name (Legal Business Name): FURAT J ZOMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 03/04/2023
Certification Date: 03/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 E LONG LAKE RD STE 145
TROY MI
48085-7010
US

IV. Provider business mailing address

3013 DEBRA CT
AUBURN HILLS MI
48326-2043
US

V. Phone/Fax

Practice location:
  • Phone: 248-385-3578
  • Fax:
Mailing address:
  • Phone: 586-914-0649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6451013194
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: