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General NPI Number Information
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NPI Number | 1861530438
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Entity Type | Individual
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Provider Name | TERRI A ZOMERLEI MD
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Gender | Female
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 4660 S HAGADORN RD STE 600
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City | EAST LANSING
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State | MI
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Zip | 48823-5383
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Country | US
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Telephone | 517-267-2460
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Fax | 517-884-8602
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Provider Business Mailing Address
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Address Line | 4070 LAKE DRIVE SE SUITE 202
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City | GRAND RAPIDS
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State | MI
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Zip | 49546
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Country | US
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Telephone | 616-464-4420
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Fax | 616-464-4354
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 57
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 4301117082
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License Number State | MI
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