Provider Demographics
NPI:1508390576
Name:STALLINGS, ZAKIYA (DO)
Entity Type:Individual
Prefix:
First Name:ZAKIYA
Middle Name:
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ZAKIYA
Other - Middle Name:
Other - Last Name:POLK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22777 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2152
Mailing Address - Country:US
Mailing Address - Phone:248-386-5200
Mailing Address - Fax:
Practice Address - Street 1:22777 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2152
Practice Address - Country:US
Practice Address - Phone:248-386-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101025785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program