Healthcare Provider Details

I. General information

NPI: 1831120666
Provider Name (Legal Business Name): THOMAS ZIPP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR MHMC-MEDICINE/NEPHROLOGY
CLEVELAND OH
44109-1900
US

IV. Provider business mailing address

2500 METROHEALTH DR MHMC-MEDICINE/NEPHROLOGY
CLEVELAND OH
44109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-4159
  • Fax:
Mailing address:
  • Phone: 216-778-4159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35042304
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number4301043158
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: