Basic Information
Provider Information
NPI: 1265434898
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAFAR
FirstName: ABIDA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 45640 SCHOENHERR RD
Address2: SUITE B
City: SHELBY TOWNSHIP
State: MI
PostalCode: 483156033
CountryCode: US
TelephoneNumber: 5862474300
FaxNumber: 5865326496
Practice Location
Address1: 2603 ELECTRIC AVE
Address2: SUITE 1
City: PORT HURON
State: MI
PostalCode: 480606588
CountryCode: US
TelephoneNumber: 5862474300
FaxNumber: 5865326496
Other Information
ProviderEnumerationDate: 08/12/2005
LastUpdateDate: 02/17/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XAZ071021MIY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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