Provider Demographics
NPI:1609867985
Name:ZAKALIK, KAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:KAROL
Middle Name:
Last Name:ZAKALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 W 13 MILE RD
Mailing Address - Street 2:STE 504
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073
Mailing Address - Country:US
Mailing Address - Phone:248-551-3020
Mailing Address - Fax:248-551-3019
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:STE 504
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-551-3020
Practice Address - Fax:248-551-3019
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301050230207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P52120OtherPTAN GROUP
MI2769781-10Medicaid
MIPTAN P00455528OtherMEDICARE RAILROAD
MI140F344180OtherBCBSM
MIGROUP DG8023OtherMEDICARE RAILROAD DG8023
MI0P52120OtherPTAN GROUP
MIPTAN P00455528OtherMEDICARE RAILROAD