MEDICARE: JOSEPH JAMES PREZZATO MD

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	207VX0000X	Obstetrics Physician	4301088750	MI

General Provider Information

NPI Number	:	1205056645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH JAMES PREZZATO MD

Provider Business Mailing Address
First Line	:	30445 NORTHWESTERN HWY
Second Line	:	SUITE 140
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3158
Country	:	US
Telephone Number	:	248-855-2229
Fax Number	:	248-702-6374

Provider Business Practice Location Address
First Line	:	30445 NORTHWESTERN HWY
Second Line	:	SUITE 140
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3158
Country	:	US
Telephone Number	:	248-855-2229
Fax Number	:	248-702-6374

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	10/17/2014

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