Healthcare Provider Details

I. General information

NPI: 1780652768
Provider Name (Legal Business Name): MARIA SIMON RIMMERMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 HURON ROAD SUITE 520
CLEVELAND OH
44115
US

IV. Provider business mailing address

PO BOX 840294
DALLAS TX
75284-0294
US

V. Phone/Fax

Practice location:
  • Phone: 216-861-5846
  • Fax: 216-861-1720
Mailing address:
  • Phone: 888-344-1160
  • Fax: 972-331-3148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.038575
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35065536R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: