Individual
AWAIS ZAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
28411 NORTHWESTERN HWY, SUITE 1050, SOUTHFIELD, MI 48034-5544
(248) 354-4709
(248) 354-4807
Mailing address
25307 SAN ROSA DR, SAINT CLAIR SHORES, MI 48081-3825
(682) 201-5503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301109076
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01347748
MEDICARE RR PTAN
IN
Enumeration date
09/08/2011
Last updated
04/29/2020
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