Provider Demographics
NPI:1710952924
Name:ZOIOPOULOS, LYNN Y (DO)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:Y
Last Name:ZOIOPOULOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43166 LOCHRISEN WAY
Mailing Address - Street 2:APT 3308
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5410
Mailing Address - Country:US
Mailing Address - Phone:312-259-2299
Mailing Address - Fax:
Practice Address - Street 1:7430 2ND AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2739
Practice Address - Country:US
Practice Address - Phone:313-748-4200
Practice Address - Fax:313-748-4187
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036082082207RC0000X
MI5101008976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL526200006OtherMEDICARE PTAN
IL036082082Medicaid
IL526200006OtherMEDICARE PTAN