Healthcare Provider Details

I. General information

NPI: 1225362759
Provider Name (Legal Business Name): ROBERT M ZIMMERMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E WILLIAM ST APT 22G
ANN ARBOR MI
48104-2427
US

IV. Provider business mailing address

555 E WILLIAM ST APT 22G
ANN ARBOR MI
48104-2427
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-4644
  • Fax:
Mailing address:
  • Phone: 734-769-4644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number4301029272
License Number StateMI

VIII. Authorized Official

Name: ROBERT ZIMMERMAN
Title or Position: DOCTOR
Credential: M.D.
Phone: 734-769-4644