MEDICARE: MS. HEATHER ASSAD ZACUR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	228114	MA

General Provider Information

NPI Number	:	1033272224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER ASSAD ZACUR M.D.

Provider Business Mailing Address
First Line	:	24327 FORD RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-1129
Country	:	US
Telephone Number	:	313-730-9260
Fax Number	:

Provider Business Practice Location Address
First Line	:	24327 FORD RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-1129
Country	:	US
Telephone Number	:	617-732-8210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	08/24/2015

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