Basic Information
| Provider Information | |||||||||
| NPI: | 1568579118 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZINK | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | JEFFREY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481081633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346475299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DR | ||||||||
| Address2: | B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349366666 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 01/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301059812 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD12188 | RI | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 04/15/2009 | 01 | RI | UNITED HEALTHCARE | OTHER | P00608585 | 01 | RAILROAD MEDICARE | OTHER | 007058810 | 01 | RI | RI MEDICARE | OTHER | 2123193 | 01 | MA MEDICAID | OTHER | 413556 | 01 | RI | BLUECHIP | OTHER | 7058810 | 05 | RI | MEDICAID | 01272009 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 1568579118 | 01 | RI | NPI | OTHER | 09262006 | 01 | RI | NHPRI | OTHER | 939025129 | 01 | RI | RI MEDICARE GROUP NUMBER | OTHER |