Basic Information
| Provider Information | |||||||||
| NPI: | 1811924061 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAMOON | ||||||||
| FirstName: | ZAFAR | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41034 MARKS DR | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483754932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859222000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6245 INKSTER RD | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481354001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344583430 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5101015676 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0153311295 | 01 | MI | BCBS INDIVIDUAL PIN | OTHER | 4715190 | 05 | MI | MEDICAID | 4715126 | 05 | MI | MEDICAID |