Provider Demographics
NPI:1063783991
Name:DILLON ZADORSKI, LINDA K (PA-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:DILLON ZADORSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:KAY
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:35047 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3613
Mailing Address - Country:US
Mailing Address - Phone:734-329-2491
Mailing Address - Fax:
Practice Address - Street 1:35047 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3613
Practice Address - Country:US
Practice Address - Phone:734-329-2491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002746363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant