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NPI Code Detail

MEDICARE: ANDREW W ZIMMERMAN M.D.

MEDICARE: ANDREW W ZIMMERMAN M.D.
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
1208000000XPediatrics Physician216753MA
22080P0008XPediatric Neurodevelopmental Disabilities Physician216753MA
32084N0402XNeurology with Special Qualifications in Child Neurology Physician216753MA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2S400104406OTHERMAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184682577
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW W ZIMMERMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number : 800-225-8885
Fax Number : 508-334-1977
Provider Business Practice Location Address
First Line : 55 LAKE AVE N
Second Line : PEDIATRIC NEUROLOGY
City : WORCESTER
State : MA
Zip : 01655-0002
Country : US
Telephone Number : 774-442-5695
Fax Number : 508-856-4287
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 05/25/2017

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