Provider Demographics
NPI:1578890174
Name:SAMIRA ZEBARI MD PC
Entity Type:Organization
Organization Name:SAMIRA ZEBARI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEBARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-557-0160
Mailing Address - Street 1:28500 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2722
Mailing Address - Country:US
Mailing Address - Phone:248-557-0160
Mailing Address - Fax:248-557-1756
Practice Address - Street 1:28500 SOUTHFIELD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-2722
Practice Address - Country:US
Practice Address - Phone:248-557-0160
Practice Address - Fax:248-557-1756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046484208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty