Provider Demographics
NPI:1891968517
Name:BOHDAN N ZAREWYCH D.O.P.C.
Entity Type:Organization
Organization Name:BOHDAN N ZAREWYCH D.O.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BOHDAN
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:ZAREWYCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-652-6640
Mailing Address - Street 1:1135 W UNIVERSITY DR
Mailing Address - Street 2:310
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1871
Mailing Address - Country:US
Mailing Address - Phone:248-652-6640
Mailing Address - Fax:248-652-3914
Practice Address - Street 1:1135 W UNIVERSITY DR
Practice Address - Street 2:310
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1871
Practice Address - Country:US
Practice Address - Phone:248-652-6640
Practice Address - Fax:248-652-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI006116207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI86338126151Medicare PIN
MIB46004Medicare UPIN