Provider Demographics
NPI:1629018296
Name:ZAMAN, SARDAR ASIM (MD,)
Entity Type:Individual
Prefix:
First Name:SARDAR
Middle Name:ASIM
Last Name:ZAMAN
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 1:6434 MEAD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2042
Mailing Address - Country:US
Mailing Address - Phone:313-770-2049
Mailing Address - Fax:
Practice Address - Street 1:6434 MEAD ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2042
Practice Address - Country:US
Practice Address - Phone:313-770-2049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083018208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4854952Medicaid
I19569Medicare UPIN
MIOP23380Medicare ID - Type Unspecified