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General NPI Number Information
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NPI Number | 1417164575
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Entity Type | Individual
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Provider Name | DANIAL JEROME ZAK D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 3681 OKEMOS RD STE 500
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City | OKEMOS
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State | MI
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Zip | 48864-6923
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Country | US
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Telephone | 517-410-8546
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Fax | 517-441-4730
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Provider Business Mailing Address
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Address Line | 3681 OKEMOS RD STE 500
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City | OKEMOS
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State | MI
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Zip | 48864-6923
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Country | US
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Telephone | 517-273-4944
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Fax | 517-441-4730
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 5101015735
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101015735
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License Number State | MI
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