1275762098 NPI number — DAVID M ZALENSKI MD PLLC

Table of content: (NPI 1275762098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275762098 NPI number — DAVID M ZALENSKI MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID M ZALENSKI MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275762098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25350 KELLY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48066-4961
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-552-8888
Provider Business Mailing Address Fax Number:
586-552-8874

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25350 KELLY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48066-4961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-552-8888
Provider Business Practice Location Address Fax Number:
586-552-8874
Provider Enumeration Date:
07/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ZALENSKI
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
586-552-8888

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P64069 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1605024251 . This is a "BLUE CROSS BLUE SHIELD OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: C5909 . This is a "MCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 121061 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5073257 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 906603700 . This is a "CIGNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1799211 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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