Provider Demographics
NPI:1285090266
Name:RIDA, HOWAYDA (PA-C)
Entity type:Individual
Prefix:
First Name:HOWAYDA
Middle Name:
Last Name:RIDA
Suffix:
Gender:F
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 1:5657 WILLIAMSON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2118
Mailing Address - Country:US
Mailing Address - Phone:347-241-9554
Mailing Address - Fax:
Practice Address - Street 1:3301 HOLBROOK ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3519
Practice Address - Country:US
Practice Address - Phone:313-872-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant