1699747543 NPI number — FERRAS ZENI MD

Table of content: FERRAS ZENI MD (NPI 1699747543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699747543 NPI number — FERRAS ZENI MD

Organization/Personal Information

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

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:
1699747543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2799 W GRAND BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48202-2608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-916-1966
Provider Business Mailing Address Fax Number:
313-916-2478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ALLINA HEALTH ORTHOPEDICS
Provider Second Line Business Practice Location Address:
225 SMITH AVENUE N, SUITE 200
Provider Business Practice Location Address City Name:
ST PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-914-8650
Provider Business Practice Location Address Fax Number:
952-946-9888
Provider Enumeration Date:
02/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  FZ074815 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4650694 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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