MEDICARE: BARBARA A ZAJDEL D.O.

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	207Q00000X	Family Medicine Physician	BZ014262	MI
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	5101014262	MI

General Provider Information

NPI Number	:	1801896469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA A ZAJDEL D.O.

Provider Business Mailing Address
First Line	:	2955 ROLLING GREEN CT
Second Line	:
City	:	MILFORD
State	:	MI
Zip	:	48380-4468
Country	:	US
Telephone Number	:	248-320-6539
Fax Number	:	248-529-3867

Provider Business Practice Location Address
First Line	:	37899 W 12 MILE RD
Second Line	:	BUILDING C-110
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3048
Country	:	US
Telephone Number	:	248-994-9090
Fax Number	:	248-994-9097

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	11/08/2012

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