=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427253475
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZARNAB SAJJAD MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2007
-----------------------------------------------------
Last Update Date | 02/08/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15855 19 MILE RD
-----------------------------------------------------
City | CLINTON TWP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48038-3504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-464-0887
-----------------------------------------------------
Fax | 734-402-0254
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 36123 SCHOOLCRAFT RD
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48150-1216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-793-6140
-----------------------------------------------------
Fax | 734-402-0254
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 4301084173
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------