Provider Demographics
NPI:1114930187
Name:ZAID, JAMIL M (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:M
Last Name:ZAID
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 ACADEMY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1120
Mailing Address - Country:US
Mailing Address - Phone:215-824-1000
Mailing Address - Fax:215-824-4460
Practice Address - Street 1:10101 ACADEMY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1120
Practice Address - Country:US
Practice Address - Phone:215-824-1000
Practice Address - Fax:215-824-4460
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002985-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111282Medicare PIN