Healthcare Provider Details
I. General information
NPI: 1205290822
Provider Name (Legal Business Name): ZHANETA ZIMMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2016
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1715 N GEORGE MASON DR STE 302
ARLINGTON VA
22205-3652
US
IV. Provider business mailing address
2353 9TH ST S
ARLINGTON VA
22204-2359
US
V. Phone/Fax
- Phone: 703-717-7851
- Fax: 703-717-7852
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | 0101267106 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: