Healthcare Provider Details

I. General information

NPI: 1285686279
Provider Name (Legal Business Name): BRENDA ZUREICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28495 HOOVER RD
WARREN MI
48093-5438
US

IV. Provider business mailing address

2188 FAWNWOOD WAY
BLOOMFIELD HILLS MI
48302-1614
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-9030
  • Fax:
Mailing address:
  • Phone: 248-798-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberBZ051910
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: