Provider Demographics
NPI:1467486969
Name:ZAIDI, SYED W (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:W
Last Name:ZAIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4530
Mailing Address - Country:US
Mailing Address - Phone:701-712-4500
Mailing Address - Fax:701-712-4098
Practice Address - Street 1:401 N 9TH ST
Practice Address - Street 2:SUITE 917
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501
Practice Address - Country:US
Practice Address - Phone:701-712-4500
Practice Address - Fax:701-712-4098
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069585207R00000X, 207RG0100X
ND8745207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1528609Medicaid
MI0P30630839Medicare PIN
LA1528609Medicaid
LA4K181F600Medicare PIN