Provider Demographics
NPI:1003265661
Name:ZAPORSKI, COLIN JEFFREY (PA)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:JEFFREY
Last Name:ZAPORSKI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26850 PROVIDENCE PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1256
Mailing Address - Country:US
Mailing Address - Phone:248-465-5140
Mailing Address - Fax:248-465-5141
Practice Address - Street 1:6525 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD TOWSHIP
Practice Address - State:MI
Practice Address - Zip Code:48323
Practice Address - Country:US
Practice Address - Phone:248-854-1064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007744363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant