Provider Demographics
NPI:1316948771
Name:ZAKEM, MICHAEL H (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:ZAKEM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 FOREMOST DR SE STE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7062
Mailing Address - Country:US
Mailing Address - Phone:616-389-1725
Mailing Address - Fax:616-954-1724
Practice Address - Street 1:5800 FOREMOST DR SE STE 200
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7062
Practice Address - Country:US
Practice Address - Phone:616-389-1800
Practice Address - Fax:616-389-1839
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007887207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F71000OtherBCBS
MI830001753OtherRR MEDICARE
MI0F76001Medicare PIN
MI0F71000OtherBCBS
MIM08620004Medicare PIN
MI0P59060001Medicare PIN