Provider Demographics
NPI:1225190895
Name:ZAREWYCH, BOHDAN NICHOLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:BOHDAN
Middle Name:NICHOLAS
Last Name:ZAREWYCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 W UNIVERSITY DR
Mailing Address - Street 2:310
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1871
Mailing Address - Country:US
Mailing Address - Phone:248-652-6640
Mailing Address - Fax:
Practice Address - Street 1:1135 W UNIVERSITY DR
Practice Address - Street 2:310
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1871
Practice Address - Country:US
Practice Address - Phone:248-652-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBZ006116207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4551887OtherAETNA
MI382157610OtherTAX IDENTIFICATION NO.
MI103954OtherCARE CHOICES
MA1686338124OtherBLUE CROSS BLUE SHIELD
MIB46004Medicare UPIN
MI4551887OtherAETNA