Provider Demographics
NPI:1871545020
Name:ZAYID, JERRY E (DPM)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:E
Last Name:ZAYID
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2559 UNION LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3555
Mailing Address - Country:US
Mailing Address - Phone:248-245-3392
Mailing Address - Fax:248-363-8652
Practice Address - Street 1:2559 UNION LAKE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-3555
Practice Address - Country:US
Practice Address - Phone:248-245-3392
Practice Address - Fax:248-363-8652
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001059213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIO-EO-2656-OOtherBLUE CROSS SUPPLIER PIN
MI0D41146OtherBLUE CROSS
MIOEO3185OtherBLUE CROSS
MI103578Medicaid
MIOEO2782OtherBLUE CROSS
MI5501440OtherBLUE CROSS
MIOH71150OtherBLUE CROSS
MI2121060Medicaid
MI2594961Medicaid
MI0D41146OtherBLUE CROSS
MIOH71150OtherBLUE CROSS
MIT99007Medicare UPIN
MI2594961Medicaid
MIOEO2782OtherBLUE CROSS
MI0821020004Medicare NSC