Provider Demographics
NPI:1790302396
Name:BACKER, ZOHEB (MD)
Entity Type:Individual
Prefix:DR
First Name:ZOHEB
Middle Name:
Last Name:BACKER
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 1:22201 MOROSS RD
Mailing Address - Street 2:SUITE 50
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-7774
Mailing Address - Fax:313-343-8747
Practice Address - Street 1:33 SOUTH 9TH STREET
Practice Address - Street 2:SUITE 700
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-503-2501
Practice Address - Fax:215-503-2506
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-06-23
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-02-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program