MEDICARE: JERRY E ZAYID DPM PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	5901001059	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0D41146	OTHER	MI	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	O-EO-2656-O	OTHER	MI	BLUE CROSS SUPPLIER PIN
5	OH71150	OTHER	MI	BLUE CROSS
6	5501440	OTHER	MI	BLUECROSS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	OEO2782	OTHER	MI	BLUE CROSS
9	OEO3185	OTHER	MH	BLUE CROSS

General Provider Information

NPI Number	:	1447347406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JERRY E ZAYID DPM PC

Provider Business Mailing Address
First Line	:	2559 UNION LAKE RD
Second Line	:
City	:	COMMERCE TWP
State	:	MI
Zip	:	48382-3555
Country	:	US
Telephone Number	:	248-245-3392
Fax Number	:	248-363-8652

Provider Business Practice Location Address
First Line	:	2559 UNION LAKE RD
Second Line	:
City	:	COMMERCE TWP
State	:	MI
Zip	:	48382-3555
Country	:	US
Telephone Number	:	248-245-3392
Fax Number	:	248-363-8652

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JERRY E ZAYID
Credential	:	DPM
Telephone Number	:	248-245-3392

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	05/02/2015

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