Provider Demographics
NPI:1902818230
Name:MICHIGAN INTERNAL MEDICINE ASSOCIATES,P.C.
Entity Type:Organization
Organization Name:MICHIGAN INTERNAL MEDICINE ASSOCIATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAZAIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-681-1880
Mailing Address - Street 1:1012 W HURON ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328
Mailing Address - Country:US
Mailing Address - Phone:248-681-1880
Mailing Address - Fax:248-681-3698
Practice Address - Street 1:1012 W HURON ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3730
Practice Address - Country:US
Practice Address - Phone:248-681-1880
Practice Address - Fax:248-681-3698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty