Provider Demographics
NPI:1558520965
Name:ZOOK, MICHELLE DENISE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DENISE
Last Name:ZOOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 HIGHWAY 160 W STE 583
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8010
Mailing Address - Country:US
Mailing Address - Phone:803-620-4728
Mailing Address - Fax:866-308-1089
Practice Address - Street 1:1646 HIGHWAY 160 W STE 583
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8010
Practice Address - Country:US
Practice Address - Phone:803-620-4728
Practice Address - Fax:866-308-1089
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442786207R00000X
SC82310207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine