Provider Demographics
NPI:1821049610
Name:ZIDE, ELIZABETH ROCHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROCHELLE
Last Name:ZIDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6441 INKSTER RD STE 232
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1316
Mailing Address - Country:US
Mailing Address - Phone:248-737-2010
Mailing Address - Fax:
Practice Address - Street 1:6441 INKSTER RD STE 232
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-1316
Practice Address - Country:US
Practice Address - Phone:248-737-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82363207P00000X
MI4301074218207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine