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General NPI Number Information
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NPI Number | 1578834651
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Entity Type | Organization
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Legal Business Name | JIAN ZU MD PLLC
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 22250 PROVIDENCE DRIVE SUITE 701
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City | SOUTHFIELD
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State | MI
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Zip | 48075-6215
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Country | US
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Telephone | 248-569-4500
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Fax | 248-569-3248
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Provider Business Mailing Address
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Address Line | 22250 PROVIDENCE DRIVE SUITE 701
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City | SOUTHFIELD
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State | MI
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Zip | 48075-6215
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Country | US
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Telephone | 248-569-4500
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Fax | 248-569-3248
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JIAN ZU
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Credential | MD
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301072649
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License Number State | MI
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