Basic Information
| Provider Information | |||||||||
| NPI: | 1003265661 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAPORSKI | ||||||||
| FirstName: | COLIN | ||||||||
| MiddleName: | JEFFREY | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26850 PROVIDENCE PKWY STE 260 | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483741256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484655140 | ||||||||
| FaxNumber: | 2484655141 | ||||||||
| Practice Location | |||||||||
| Address1: | 6525 W MAPLE RD | ||||||||
| Address2: | |||||||||
| City: | WEST BLOOMFIELD TOWSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488541064 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 5601007744 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.