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General NPI Number Information
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NPI Number | 1023220159
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Entity Type | Organization
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Legal Business Name | JIAN ZU, M. D., PLLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22250 PROVIDENCE DR. SUITE 403
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City | SOUTHFIELD
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State | MI
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Zip | 48075
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Country | US
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Telephone | 248-569-4500
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Fax | 248-569-2126
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Provider Business Mailing Address
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Address Line | 22250 PROVIDENCE DR. SUITE 403
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City | SOUTHFIELD
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State | MI
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Zip | 48075
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Country | US
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Telephone | 248-569-4500
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Fax | 248-569-2126
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Authorized Official
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Title or Position | OWNER
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Name | JIAN ZU
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Credential | M.D.
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Telephone | 248-569-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 4301072649
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License Number State | MI
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