Provider Demographics
NPI:1568553667
Name:ZEMNICKAS, WILLIAM V II (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:V
Last Name:ZEMNICKAS
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:844 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3027
Mailing Address - Country:US
Mailing Address - Phone:810-664-4100
Mailing Address - Fax:810-664-9250
Practice Address - Street 1:844 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3027
Practice Address - Country:US
Practice Address - Phone:810-664-4100
Practice Address - Fax:810-664-9250
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIWZ007094208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI136702910Medicaid
MI020002599OtherRAILROAD MEDICARE
MI0254410174OtherBCBSM PROVIDER NUMBER
MI020D410180OtherBLUECARE NETWORK PROV #
MI020D410180OtherBLUECARE NETWORK PROV #
MI0254410174OtherBCBSM PROVIDER NUMBER