Provider Demographics
NPI:1336782390
Name:SIDI, ZAID (PA-C)
Entity Type:Individual
Prefix:
First Name:ZAID
Middle Name:
Last Name:SIDI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8419 E QUARTERHORSE TRL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1365
Mailing Address - Country:US
Mailing Address - Phone:602-592-9682
Mailing Address - Fax:
Practice Address - Street 1:8419 E QUARTERHORSE TRL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1365
Practice Address - Country:US
Practice Address - Phone:602-592-9682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant