Healthcare Provider Details

I. General information

NPI: 1407176126
Provider Name (Legal Business Name): MARTIN E. ZIPSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 N DREAMY DRAW DR
PHOENIX AZ
85020-5212
US

IV. Provider business mailing address

7320 N DREAMY DRAW DR
PHOENIX AZ
85020-5212
US

V. Phone/Fax

Practice location:
  • Phone: 602-952-7480
  • Fax: 602-952-8987
Mailing address:
  • Phone: 602-952-7480
  • Fax: 602-952-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC36156
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9302
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: