Provider Demographics
NPI:1326162173
Name:BARACZ-ZIMMERMAN, ELIZABETH ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:BARACZ-ZIMMERMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7393 BROADVIEW RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4444
Mailing Address - Country:US
Mailing Address - Phone:216-642-3668
Mailing Address - Fax:216-573-0769
Practice Address - Street 1:7393 BROADVIEW RD
Practice Address - Street 2:SUITE F
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-4444
Practice Address - Country:US
Practice Address - Phone:216-642-3668
Practice Address - Fax:216-573-0769
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3455213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2777777Medicaid
OH5299569OtherCIGNA
OH000000521894OtherANTHEM
OH393003OtherWELLCARE
OH7034913OtherAETNA
OH5299569OtherCIGNA
OH393003OtherWELLCARE