Provider Demographics
NPI:1609165687
Name:ZIMMERMAN, DAVID CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 NEW HAMPSHIRE AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4759
Mailing Address - Country:US
Mailing Address - Phone:646-345-8477
Mailing Address - Fax:
Practice Address - Street 1:50 HOSPITAL HILL RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2092
Practice Address - Country:US
Practice Address - Phone:860-364-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275394207P00000X
OH34.011010207P00000X
NH18767207P00000X
PAOS016916207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34.011010OtherOHIO MEDICAL BOARD
KY04451OtherKY MEDICAL BOARD
PAOS016916OtherMEDICAL LICENSE
NY275394OtherMEDICAL LICENSE