Basic Information
| Provider Information | |||||||||
| NPI: | 1336513530 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AHMAD R ZEIBO MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 87763 | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481870763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7348464517 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Practice Location | |||||||||
| Address1: | 2105 WEST RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | TRENTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481833897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346757777 | ||||||||
| FaxNumber: | 7346757785 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2015 | ||||||||
| LastUpdateDate: | 11/25/2015 | ||||||||
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| AuthorizedOfficialLastName: | ZEIBO | ||||||||
| AuthorizedOfficialFirstName: | AHMAD | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7348464517 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301074858 | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.