MEDICARE: DR. ZISHAN ALIBHAI M.D., FRCPC

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	2085R0001X	Radiation Oncology Physician	(PENDING)	MI

General Provider Information

NPI Number	:	1578846440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZISHAN ALIBHAI M.D., FRCPC

Provider Business Mailing Address
First Line	:	2524 TIMBERWYCK TRAIL DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48098-4104
Country	:	US
Telephone Number	:	248-566-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 E CANFIELD ST
Second Line	:	1212 SCOTT HALL
City	:	DETROIT
State	:	MI
Zip	:	48201-1928
Country	:	US
Telephone Number	:	248-795-4276
Fax Number	:

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

Provider Enumeration Date	:	09/27/2011
Last Update Date	:	09/27/2011

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