Healthcare Provider Details

I. General information

NPI: 1316901267
Provider Name (Legal Business Name): DAVID A. ZIMRIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2006
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-3244
  • Fax: 410-328-3826
Mailing address:
  • Phone: 410-328-3244
  • Fax: 410-328-3826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD33475
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD33475
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: