Ahmad R Zeibo MD PLLC

Key facts

NPI

1336513530

Entity type

Organization (NPI type 2)

Primary specialty

Internal Medicine Physician 207R00000X

License

4301074858 (MI)

Legal business name

AHMAD R ZEIBO MD PLLC

Practice address

15450 Northline Rd Ste 102
Southgate, MI 48195-2490

Phone

(734) 720-7270

Fax

(734) 288-0934

NPI assigned

Nov 25, 2015

Organization subpart

No

Authorized official

Name

Ahmad R Zeibo, MD NPI 1922092816

Title

Member

Phone

(734) 846-4517

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmad Zeibo, M.D. Internal Medicine Physician · Troy, MI · NPI 1922092816
  Medicare reassignment NPD Authorized official INTERNAL MEDICINE · MI

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 26, 2022.

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672012800000",
    "number": "1336513530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87763",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481870763",
            "telephone_number": "734-846-4517",
            "fax_number": "888-770-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 NORTHLINE RD STE 102",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952490",
            "telephone_number": "734-720-7270",
            "fax_number": "734-288-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHMAD R ZEIBO MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A",
        "authorized_official_last_name": "ZEIBO",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "734-846-4517",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301074858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Southgate, MI · Internal Medicine Physician in Michigan