Healthcare Provider Details

I. General information

NPI: 1972604742
Provider Name (Legal Business Name): GRACE EDITH ZIEM MD MPH MS DRPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16926 EYLERS VALLEY RD
EMMITSBURG MD
21727-9729
US

IV. Provider business mailing address

16926 EYLERS VALLEY RD
EMMITSBURG MD
21727-9729
US

V. Phone/Fax

Practice location:
  • Phone: 301-241-4347
  • Fax: 301-241-4348
Mailing address:
  • Phone: 301-241-4347
  • Fax: 301-241-4348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License NumberD0018732
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: