Provider Demographics
NPI:1437418373
Name:CAZAL, ANIBAL SR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:
Last Name:CAZAL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18289 BLUE HERON POINTE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-9262
Mailing Address - Country:US
Mailing Address - Phone:248-380-1555
Mailing Address - Fax:
Practice Address - Street 1:18289 BLUE HERON POINTE DR
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-9262
Practice Address - Country:US
Practice Address - Phone:248-380-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2012-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301031508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine