Provider Demographics
NPI:1962419267
Name:ZELENAK, DARYL J (DO)
Entity type:Individual
Prefix:DR
First Name:DARYL
Middle Name:J
Last Name:ZELENAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:559 PROGRESS ST STE E
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9399
Mailing Address - Country:US
Mailing Address - Phone:989-345-8113
Mailing Address - Fax:989-345-7484
Practice Address - Street 1:559 PROGRESS ST STE E
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9399
Practice Address - Country:US
Practice Address - Phone:989-345-8113
Practice Address - Fax:989-345-3687
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013471207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4453120Medicaid
MI147470OtherEYEMED
0Z96211Medicare ID - Type Unspecified