Provider Demographics
NPI:1316979032
Name:ZAID, GARY J (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:J
Last Name:ZAID
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 1:111 E WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4815
Mailing Address - Country:US
Mailing Address - Phone:414-290-6700
Mailing Address - Fax:414-290-6755
Practice Address - Street 1:6308 8TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5031
Practice Address - Country:US
Practice Address - Phone:262-656-2367
Practice Address - Fax:262-656-2366
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-070701207P00000X
CAG50513207P00000X
WI27518-020207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI930107050OtherMEDICARE RAILROAD
IL036070701Medicaid
WI30782900Medicaid
WI930044450OtherMEDICARE RAILROAD
WI930063531OtherMEDICARE RAILROAD
ILP00043247OtherMEDICARE RAILROAD
WI0032-68655Medicare ID - Type Unspecified
WI0015-60045Medicare ID - Type Unspecified
WI0008-32350Medicare ID - Type Unspecified
WI930107050OtherMEDICARE RAILROAD
ILP00043247OtherMEDICARE RAILROAD
WI0015-32280Medicare ID - Type Unspecified
WI930063531OtherMEDICARE RAILROAD
WI0016-10006Medicare ID - Type Unspecified
ILL99982Medicare ID - Type Unspecified
C42622Medicare UPIN
WI0008-17130Medicare ID - Type Unspecified
WI30782900Medicaid