Provider Demographics
NPI:1275673121
Name:ZIAD BERRI MD PC
Entity Type:Organization
Organization Name:ZIAD BERRI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-581-4511
Mailing Address - Street 1:14515 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3151
Mailing Address - Country:US
Mailing Address - Phone:313-581-4511
Mailing Address - Fax:313-624-8851
Practice Address - Street 1:14515 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3151
Practice Address - Country:US
Practice Address - Phone:313-581-4511
Practice Address - Fax:313-624-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108233932OtherBCBSM
MI1108233932OtherBCBSM
MI0M15550Medicare ID - Type Unspecified