Healthcare Provider Details

I. General information

NPI: 1619034865
Provider Name (Legal Business Name): ZAKARIA & ZAKARIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 KIRTS BLVD SUITE #400
TROY MI
48084-4881
US

IV. Provider business mailing address

1080 KIRTS BLVD SUITE #400
TROY MI
48084-4881
US

V. Phone/Fax

Practice location:
  • Phone: 248-362-2660
  • Fax: 248-362-0662
Mailing address:
  • Phone: 248-362-2660
  • Fax: 248-362-0662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTOINE G ZAKARIA
Title or Position: OFC MGR
Credential:
Phone: 248-362-2660