Provider Demographics
NPI:1578834651
Name:JIAN ZU MD PLLC
Entity Type:Organization
Organization Name:JIAN ZU MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-569-4500
Mailing Address - Street 1:22250 PROVIDENCE DRIVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6215
Mailing Address - Country:US
Mailing Address - Phone:248-569-4500
Mailing Address - Fax:248-569-3248
Practice Address - Street 1:22250 PROVIDENCE DRIVE
Practice Address - Street 2:SUITE 701
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6215
Practice Address - Country:US
Practice Address - Phone:248-569-4500
Practice Address - Fax:248-569-3248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072649207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty