Provider Demographics
NPI:1063901171
Name:CHOUDHRY, ZAIN (MD)
Entity type:Individual
Prefix:
First Name:ZAIN
Middle Name:
Last Name:CHOUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26041 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1855
Mailing Address - Country:US
Mailing Address - Phone:734-752-1868
Mailing Address - Fax:
Practice Address - Street 1:3031 W GRAND BLVD STE 450
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3026
Practice Address - Country:US
Practice Address - Phone:734-752-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015035992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry