Healthcare Provider Details

I. General information

NPI: 1104082999
Provider Name (Legal Business Name): ERIN M ZIMNY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD DEPARTMENT OF EMERGENCY MEDICINE
DETROIT MI
48202
US

IV. Provider business mailing address

2799 W GRAND BLVD DEPARTMENT OF EMERGENCY MEDICINE
DETROIT MI
48202
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-1558
  • Fax:
Mailing address:
  • Phone: 313-916-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301099322
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number4301099322
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: