MEDICARE: ZOSIMO MAXIMO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35034200	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265484380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZOSIMO MAXIMO M.D.

Provider Business Mailing Address
First Line	:	1350 CLARK ST
Second Line	:
City	:	CAMBRIDGE
State	:	OH
Zip	:	43725-9614
Country	:	US
Telephone Number	:	740-439-0733
Fax Number	:	740-439-8996

Provider Business Practice Location Address
First Line	:	1200 CLARK ST
Second Line	:
City	:	CAMBRIDGE
State	:	OH
Zip	:	43725-9611
Country	:	US
Telephone Number	:	740-439-0733
Fax Number	:	740-439-8996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/08/2007

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Directions to “ ZOSIMO MAXIMO M.D.” Practice Location

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