Liss, Zachary Jonathan

Liss, Zachary Jonathan is an individual health care provider with primary practice located at 20952 E 12 Mile Rd Suite 200, Saint Clair Shores MI 48081-3200. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Urology, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Pediatric Urology is his primary health care specialty. Liss, Zachary Jonathan can be contacted via phone (586) 771-4820.

Contact Information

Primary practice address
20952 E 12 Mile Rd Suite 200 Saint Clair Shores MI 48081-3200
Phone: (586) 771-4820
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X 4301092867 Michigan
Allopathic & Osteopathic Physicians / Urology 208800000X 4301092867 Michigan

Profile Details

NPI number 1457592990
LBN Legal business name Liss, Zachary Jonathan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2009
Last updated Aug 6th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457592990 NPPES
Michigan Other CB9133 RAILROAD MEDICARE
Michigan Other 340E062730 RAILROAD MEDICARE

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