MEDICARE: DR. ISIDORE NONE ZAIDERMAN D.P.M

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	213EP1101X	Primary Podiatric Medicine Podiatrist	P0245	DC

General Provider Information

NPI Number	:	1841385192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISIDORE NONE ZAIDERMAN D.P.M

Provider Business Mailing Address
First Line	:	1808 CONNECTICUT AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-5729
Country	:	US
Telephone Number	:	202-332-3898
Fax Number	:	202-387-7798

Provider Business Practice Location Address
First Line	:	1808 CONNECTICUT AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-5729
Country	:	US
Telephone Number	:	202-332-3898
Fax Number	:	202-387-7798

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/06/2023

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