Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 4301077700 | MI |
NPI | 1033104773 |
---|---|
Provider Name | Dr. Daniel Seth Zuckerbrod |
First Address | Bloomfield Hills, MI 48302-5027 |
Second Address | Detroit, MI 48235-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 29/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4604360 | (05) | MI |
4604379 | (05) | MI |
4604388 | (05) | MI |
I23193 | (02) | MI |