Healthcare Provider Details

I. General information

NPI: 1497497903
Provider Name (Legal Business Name): ZACKARY JOSEPH CLOR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7116 HIGHLAND RD
WATERFORD MI
48327-1503
US

IV. Provider business mailing address

7116 HIGHLAND RD
WATERFORD MI
48327-1503
US

V. Phone/Fax

Practice location:
  • Phone: 248-666-8807
  • Fax: 248-666-7709
Mailing address:
  • Phone: 248-666-8807
  • Fax: 248-666-7709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901400574
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: