Provider Demographics
NPI:1538166152
Name:ZIDEL, PAUL I (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:ZIDEL
Suffix:I
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 1:2929 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8034
Mailing Address - Country:US
Mailing Address - Phone:602-470-5000
Mailing Address - Fax:
Practice Address - Street 1:2601 E ROOSEVELT ST
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4973
Practice Address - Country:US
Practice Address - Phone:602-344-5371
Practice Address - Fax:602-344-5048
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2015-02-27
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
FLME61176207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266090301Medicaid
FL266090300Medicaid
AZ358302Medicaid
FLD72628Medicare UPIN
FL266090300Medicaid
AZZ159597Medicare PIN
FLK6087Medicare PIN