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Organization
LAZ MEDICAL GROUP PC
Active
Organization
LAZ MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZAKARI TATA MD (PHYSICIAN OWNER)
(248) 569-7550
Entity
Organization
Contact information
Practice address
20755 GREENFIELD RD, #1101, SOUTHFIELD, MI 48075-5403
(248) 569-7550
(313) 561-0277
Mailing address
PO BOX 250005, W BLOOMFIELD, MI 48325-0005
(248) 569-7550
(313) 561-0277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
NULL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
07/20/2005
Last updated
05/06/2025
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