Provider Demographics
NPI:1528259835
Name:FAYDA ZAKARIA M.D.P.C.
Entity type:Organization
Organization Name:FAYDA ZAKARIA M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-562-6607
Mailing Address - Street 1:2200 MONROE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124
Mailing Address - Country:US
Mailing Address - Phone:313-562-6607
Mailing Address - Fax:313-562-5851
Practice Address - Street 1:2200 MONROE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-562-6607
Practice Address - Fax:313-562-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty