Provider Demographics
NPI:1184832990
Name:ZYWICKE, HOLLY ANN (MD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:ZYWICKE
Suffix:
Gender:F
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:PO BOX 2705
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804
Mailing Address - Country:US
Mailing Address - Phone:256-533-1600
Mailing Address - Fax:256-539-0856
Practice Address - Street 1:201 GOVERNORS DR SW FL 1
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5171
Practice Address - Country:US
Practice Address - Phone:256-533-1600
Practice Address - Fax:256-539-0856
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA066446207T00000X
MI4301104542207T00000X
AL27884207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery