MEDICARE: DR. PHILIP SCOTT ZIMMERMAN 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	207P00000X	Emergency Medicine Physician	21652	IA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730165358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP SCOTT ZIMMERMAN M.D.

Provider Business Mailing Address
First Line	:	350 N GRANDVIEW AVE
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-6388
Country	:	US
Telephone Number	:	563-582-1881
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 N GRANDVIEW AVE
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-6388
Country	:	US
Telephone Number	:	563-582-1881
Fax Number	:

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	08/14/2009

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