MEDICARE: DR. BRUCE E ZIMMERMAN 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	04-18507	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	D446804	OTHER		MEDICARE KC
5	040013096	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	263013	OTHER	HEALTHLINK
3	13644031	OTHER	BCBS KC
4	402512	OTHER	BCBS KS

General Provider Information

NPI Number	:	1841297934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE E ZIMMERMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 874480
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64187-0001
Country	:	US
Telephone Number	:	913-764-2737
Fax Number	:	913-764-7502

Provider Business Practice Location Address
First Line	:	20375 W. 151ST ST
Second Line	:	SUITE 106A
City	:	OLATHE
State	:	KS
Zip	:	66061-5353
Country	:	US
Telephone Number	:	913-764-2737
Fax Number	:	913-764-7502

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	03/01/2012

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Directions to “ DR. BRUCE E ZIMMERMAN MD” Practice Location

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