Provider Demographics
NPI:1063686566
Name:ZIMMER, DAVID MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARC
Last Name:ZIMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 OLD COURTHOUSE RD
Mailing Address - Street 2:B
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3863
Mailing Address - Country:US
Mailing Address - Phone:703-288-0494
Mailing Address - Fax:703-893-2837
Practice Address - Street 1:8308 OLD COURTHOUSE RD
Practice Address - Street 2:B
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3863
Practice Address - Country:US
Practice Address - Phone:703-288-0494
Practice Address - Fax:703-893-2837
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVIRGINIA2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry