Provider Demographics
NPI:1134718711
Name:ZINDANI, ANTESAR (PA-C)
Entity type:Individual
Prefix:
First Name:ANTESAR
Middle Name:
Last Name:ZINDANI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5732 FORDHAM CIR APT 206
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3350
Mailing Address - Country:US
Mailing Address - Phone:248-470-7304
Mailing Address - Fax:
Practice Address - Street 1:5250 AUTO CLUB DR STE 200
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2619
Practice Address - Country:US
Practice Address - Phone:313-914-5591
Practice Address - Fax:313-982-9847
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2024-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601010180363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant