Provider Demographics
NPI:1124041025
Name:HODA A ZAKI, M.D., P.C.
Entity Type:Organization
Organization Name:HODA A ZAKI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HODA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-877-7376
Mailing Address - Street 1:5050 VILLA LINDE PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3436
Mailing Address - Country:US
Mailing Address - Phone:810-877-7376
Mailing Address - Fax:810-230-9368
Practice Address - Street 1:5050 VILLA LINDE PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3436
Practice Address - Country:US
Practice Address - Phone:810-877-7376
Practice Address - Fax:810-230-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051532207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE68055Medicare UPIN
MI0P12860Medicare ID - Type Unspecified