Provider Demographics
NPI:1801896469
Name:ZAJDEL, BARBARA A (DO)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:ZAJDEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2955 ROLLING GREEN CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-4468
Mailing Address - Country:US
Mailing Address - Phone:248-320-6539
Mailing Address - Fax:248-529-3867
Practice Address - Street 1:37899 W 12 MILE RD
Practice Address - Street 2:BUILDING C-110
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3048
Practice Address - Country:US
Practice Address - Phone:248-994-9090
Practice Address - Fax:248-994-9097
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2012-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIBZ014262207Q00000X
MI5101014262204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH27027Medicare UPIN
MI0N94980002Medicare ID - Type Unspecified