Healthcare Provider Details

I. General information

NPI: 1245221357
Provider Name (Legal Business Name): TAMELA ZIMMERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 STRAIGHT ST
CINCINNATI OH
45219-1018
US

IV. Provider business mailing address

PO BOX 632745
CINCINNATI OH
45263-2745
US

V. Phone/Fax

Practice location:
  • Phone: 513-559-2238
  • Fax:
Mailing address:
  • Phone: 513-559-2898
  • Fax: 513-475-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35052333
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: