Organization
SOUTHEAST MICHIGAN NEUROSURGERY PLLC
Active
Organization
SOUTHEAST MICHIGAN NEUROSURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAROL ZAKALIK M.D. (PRESIDENT)
(248) 551-3020
Entity
Organization
Contact information
Practice address
3535 WEST 13 MILE ROAD, SUITE 504, ROYAL OAK, MI 48073
(248) 551-3020
(248) 551-3019
Mailing address
3535 WEST 13 MILE ROAD, SUITE 504, ROYAL OAK, MI 48073
(248) 551-3020
(248) 551-3019
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301050230
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140F344180
BCBSM
MI
05
—
2769781-10
—
MI
01
—
DG8023
MEDICARE RAILROAD
MI
01
—
OP52120
PTAN
MI
01
—
PTAN P00455528
MEDICARE RAILROAD
MI
Enumeration date
12/31/2007
Last updated
10/21/2016
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