Provider Demographics
NPI:1639327687
Name:CARDENAS, ZENAIDA (MD)
Entity Type:Individual
Prefix:
First Name:ZENAIDA
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 CADIEUX RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2273
Mailing Address - Country:US
Mailing Address - Phone:313-343-9911
Mailing Address - Fax:313-343-9910
Practice Address - Street 1:4900 CADIEUX RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2273
Practice Address - Country:US
Practice Address - Phone:313-343-9911
Practice Address - Fax:313-343-9910
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301038582207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1659303154OtherCOMMERCIAL
MI1659303154OtherCOMMERCIAL