Healthcare Provider Details

I. General information

NPI: 1891075412
Provider Name (Legal Business Name): JERRY E ZAYID DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 07/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2559 UNION LAKE RD
COMMERCE TWP MI
48382-3555
US

IV. Provider business mailing address

2559 UNION LAKE RD
COMMERCE TWP MI
48382-3555
US

V. Phone/Fax

Practice location:
  • Phone: 248-245-3392
  • Fax: 248-363-8652
Mailing address:
  • Phone: 248-245-3392
  • Fax: 248-363-8652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number5901001059
License Number StateMI

VIII. Authorized Official

Name: DR. JERRY E ZAYID
Title or Position: OWNER
Credential: DPM
Phone: 248-245-3392