Provider Demographics
NPI:1497725501
Name:ZYZDA, MICHAEL J (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:ZYZDA
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 1:2727 BRYANT ST STE 400
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4170
Mailing Address - Country:US
Mailing Address - Phone:720-855-9214
Mailing Address - Fax:720-855-9291
Practice Address - Street 1:2727 BRYANT ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4170
Practice Address - Country:US
Practice Address - Phone:720-855-9214
Practice Address - Fax:720-855-9291
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO430213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01004308Medicaid
CO01004308Medicaid
COCA1123Medicare PIN