Basic Information
Provider Information
NPI: 1174738033
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZEIN
FirstName: AMINE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26696 LAWRENCE DR
Address2:  
City: DEARBORN HEIGHTS
State: MI
PostalCode: 481273379
CountryCode: US
TelephoneNumber: 3137309114
FaxNumber:  
Practice Location
Address1: 6245 INKSTER RD
Address2:  
City: GARDEN CITY
State: MI
PostalCode: 481354001
CountryCode: US
TelephoneNumber: 7344583300
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 04/08/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X5101015060MIY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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