Provider Demographics
NPI:1144480534
Name:LOVE, ZACHARY IAN (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:IAN
Last Name:LOVE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:
Practice Address - Street 1:221 MICHIGAN ST NE
Practice Address - Street 2:SUITE 406
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2543
Practice Address - Country:US
Practice Address - Phone:616-391-5701
Practice Address - Fax:616-391-5901
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017677207X00000X
NC2013-01285207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery