Provider Demographics
NPI:1669473880
Name:HUSAMI, ZAFER (MD)
Entity Type:Individual
Prefix:
First Name:ZAFER
Middle Name:
Last Name:HUSAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:22030 PARK ST
Mailing Address - Street 2:STE 103
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2854
Mailing Address - Country:US
Mailing Address - Phone:313-562-2611
Mailing Address - Fax:313-562-7025
Practice Address - Street 1:22030 PARK ST
Practice Address - Street 2:STE 103
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2854
Practice Address - Country:US
Practice Address - Phone:313-562-2611
Practice Address - Fax:313-562-7025
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301057510207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110173115C30371OtherTRAVELERS MEDICARE
MIC6120OtherM CARE
MI204980OtherFEDERAL BLACK LUNG
MI2714AOtherCAPE HEALTH PLAN
MI101571OtherGREAT LAKES HEALTH PLAN
MI3520336Medicaid
MIP61541 G02484OtherBLUE CARE NETWORK
MI125437OtherCARE CHOICES
MI110Q26434OtherBCBS
MI5019367OtherAETNA
G25493Medicare UPIN
MI3520336Medicaid