Provider Demographics
NPI:1841366218
Name:ZINBERG, EPHRAIM M (MD)
Entity type:Individual
Prefix:DR
First Name:EPHRAIM
Middle Name:M
Last Name:ZINBERG
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 1:25700 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2049
Mailing Address - Country:US
Mailing Address - Phone:248-752-6328
Mailing Address - Fax:248-552-6278
Practice Address - Street 1:28300 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3704
Practice Address - Country:US
Practice Address - Phone:248-626-0135
Practice Address - Fax:248-626-0150
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077701207XS0106X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
700H262250OtherBLUE CROSS-BLUE CROSS
EZ077701OtherCHAMPUS-CHAMPUS
EZ077701OtherCOMMERCIAL-COMMERCIAL NUMBER
MI455802410Medicaid
B82701Medicare UPIN
MI455802410Medicaid
MI0P30630829Medicare PIN