Provider Demographics
NPI:1184821829
Name:ABDALLAH E ZAMARIA MD AND BARBARA HENIKE MD PC
Entity Type:Organization
Organization Name:ABDALLAH E ZAMARIA MD AND BARBARA HENIKE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDALLAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZAMARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-772-3244
Mailing Address - Street 1:24001 GREATER MACK AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1471
Mailing Address - Country:US
Mailing Address - Phone:586-772-3244
Mailing Address - Fax:586-772-8550
Practice Address - Street 1:24001 GREATER MACK AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1471
Practice Address - Country:US
Practice Address - Phone:586-772-3244
Practice Address - Fax:586-772-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAZ034941103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E06001Medicare ID - Type UnspecifiedMEDICARE GROUP ID