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General NPI Number Information
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NPI Number | 1477555951
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Entity Type | Individual
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Provider Name | DONALD DAVID NIMMER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2005
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 4600 W LOOMIS RD SUITE 130
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City | GREENFIELD
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State | WI
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Zip | 53220-4858
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Country | US
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Telephone | 414-389-4900
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Fax | 414-465-4606
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Provider Business Mailing Address
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Address Line | 4935 S 76TH ST STE 101
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City | GREENFIELD
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State | WI
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Zip | 53220-4305
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Country | US
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Telephone | 414-777-3100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29494
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License Number State | WI
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