Healthcare Provider Details

I. General information

NPI: 1861523334
Provider Name (Legal Business Name): STEVEN S. ZELDES MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 W MAPLE RD #200
WEST BLOOMFIELD MI
48322-4406
US

IV. Provider business mailing address

6010 W MAPLE RD #200
WEST BLOOMFIELD MI
48322-4406
US

V. Phone/Fax

Practice location:
  • Phone: 248-737-6955
  • Fax: 248-737-8759
Mailing address:
  • Phone: 248-737-6955
  • Fax: 248-737-8759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301067910
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number4301067910
License Number StateMI

VIII. Authorized Official

Name: DR. STEVEN S ZELDES
Title or Position: PRESEDENT
Credential: MD
Phone: 248-737-6955