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General NPI Number Information
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NPI Number | 1861462608
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Entity Type | Organization
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Legal Business Name | MARC H. ZIMMERMAN, M.D.P.C.
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 1840 MESQUITE AVE SUITE G
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5771
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Country | US
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Telephone | 928-453-2663
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Fax | 928-453-1452
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Provider Business Mailing Address
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Address Line | 1840 MESQUITE AVE SUITE G
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5771
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Country | US
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Telephone | 928-453-2663
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Fax | 928-453-1452
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. MARC H. ZIMMERMAN
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Credential | M.D.
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Telephone | 928-453-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 14797
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License Number State | AZ
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