MEDICARE: DR. ZAHER K OTROCK M.D., PH.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	207ZC0006X	Clinical Pathology Physician	35.147173	OH
2	207ZB0001X	Blood Banking & Transfusion Medicine Physician	35.147173	OH

General Provider Information

NPI Number	:	1477995306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZAHER K OTROCK M.D., PH.D.

Provider Business Mailing Address
First Line	:	2799 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-2608
Country	:	US
Telephone Number	:	216-246-6690
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-445-4619
Fax Number	:

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

Provider Enumeration Date	:	07/19/2013
Last Update Date	:	01/26/2025

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