Provider Demographics
NPI:1598891863
Name:JOHNSON-MENDOZA, ZENZILE A (DO)
Entity Type:Individual
Prefix:DR
First Name:ZENZILE
Middle Name:A
Last Name:JOHNSON-MENDOZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ZENZILE
Other - Middle Name:A
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9545 GLENHILL DR
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48198-2601
Mailing Address - Country:US
Mailing Address - Phone:734-483-1307
Mailing Address - Fax:
Practice Address - Street 1:718 N MACOMB ST
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-7815
Practice Address - Country:US
Practice Address - Phone:734-240-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016237207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty