Provider Demographics
NPI:1275805483
Name:ZACHARZEWSKI, KATIE PERZ (DO)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:PERZ
Last Name:ZACHARZEWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:LAUREN
Other - Last Name:PERZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:30200 TELEGRAPH RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4502
Mailing Address - Country:US
Mailing Address - Phone:248-258-5058
Mailing Address - Fax:
Practice Address - Street 1:30200 TELEGRAPH RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4502
Practice Address - Country:US
Practice Address - Phone:248-258-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020886207L00000X
MI5315064208207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology