Marc Zuckman, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

4301053779 Issued in MI

Practice address

16001 W 9 Mile Rd
Dept of Pathology
Southfield, MI 48075-4818

Phone

(248) 849-3000

Fax

(248) 849-5392

NPI assigned

Aug 9, 2005

Last updated

Apr 23, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan Diagnostic Pathology Specialists PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Southfield, MI
  • NPI 1609020320
  Authorized official Same address or phone
• Hospital Consolidated Laboratories

  • Clinical Medical Laboratory
  • Southfield, MI
  • NPI 1962475780
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1962403329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1468",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "480991468",
            "telephone_number": "248-746-0342",
            "fax_number": "248-746-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "address_2": "DEPT OF PATHOLOGY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000",
            "fax_number": "248-849-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKMAN",
        "first_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301053779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279841510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hashem H Zokary, MD
• Dunia Zoma
• Meghan M Zorza, CRNA
• Jian Zu, MD
• Vincent Zubalik
• Marc Thomas Zughaib, DO
• Marcel E Zughaib, M.D.
• Chana Aidel Zuroff
• Tehila Zuroff, LLMSW
• ZZ Medisource LLC

• Anatomic Pathology & Clinical Pathology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.