MEDICARE: SAMER ZAKHOUR 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	207R00000X	Internal Medicine Physician	35.144709	OH
2	207R00000X	Internal Medicine Physician	4351044589	MI

General Provider Information

NPI Number	:	1669932786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMER ZAKHOUR MD

Provider Business Mailing Address
First Line	:	2799 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-2608
Country	:	US
Telephone Number	:	313-916-1888
Fax Number	:	313-916-1394

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2608
Country	:	US
Telephone Number	:	707-373-8824
Fax Number	:

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

Provider Enumeration Date	:	03/24/2019
Last Update Date	:	04/28/2023

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