Individual
PAUL K FOZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50505 SCHOENHERR RD, SUITE 340, SHELBY TOWNSHIP, MI 48315-3140
(586) 731-8400
(586) 731-8406
Mailing address
1746 MOMENTUM PL, CHICAGO, IL 60689-5317
(586) 731-8400
(586) 731-8406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301080819
MI
208M00000X
Hospitalist Physician
Primary
4301080819
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0827486
BCBS
MI
01
—
1073593174
NPI
MI
05
—
474607010
—
MI
Enumeration date
01/17/2006
Last updated
05/26/2010
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