Provider Demographics
NPI:1407176126
Name:ZIPSER, MARTIN E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:E
Last Name:ZIPSER
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 1:7320 N DREAMY DRAW DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5212
Mailing Address - Country:US
Mailing Address - Phone:602-952-7480
Mailing Address - Fax:602-952-8987
Practice Address - Street 1:7320 N DREAMY DRAW DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5212
Practice Address - Country:US
Practice Address - Phone:602-952-7480
Practice Address - Fax:602-952-8987
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC36156208600000X
AZ9302208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ9302OtherSTATE MEDICAL LICENSE