Healthcare Provider Details

I. General information

NPI: 1972504025
Provider Name (Legal Business Name): ROBERT F ZIMMERMAN III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 FRANKLIN HEALTH CMNS
FARMINGTON ME
04938-6144
US

IV. Provider business mailing address

65 CENTER ST
YARMOUTH ME
04096-7930
US

V. Phone/Fax

Practice location:
  • Phone: 207-779-2456
  • Fax: 207-779-2496
Mailing address:
  • Phone: 207-420-5358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD15106
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: