MEDICARE: DR. WAYNE MICHAEL ZIMMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	MD045449L	PA

General Provider Information

NPI Number	:	1174634836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE MICHAEL ZIMMER MD

Provider Business Mailing Address
First Line	:	3126 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1132
Country	:	US
Telephone Number	:	724-656-5050
Fax Number	:	724-658-2648

Provider Business Practice Location Address
First Line	:	3126 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1132
Country	:	US
Telephone Number	:	724-656-5050
Fax Number	:	724-658-2648

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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