Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 4301060783 | MI |
NPI | 1033313028 |
---|---|
Provider Name | Dr. Abbas Zagnoon |
First Address | West Bloomfield, MI 48323-3517 |
Second Address | Jeddah, SAUDI ARABIA 21499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |