Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 4301048444 | MI |
NPI | 1033179973 |
---|---|
Provider Name | Dana Zakalik |
First Address | Rochester Hills, MI 48307-6122 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3452890 | (05) | MI |
A79484 | (02) | MI |