Provider Demographics
NPI:1639126394
Name:ZIRM, RICHARD J (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:ZIRM
Suffix:
Gender:M
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-626-6161
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:SUITE C308
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3329
Practice Address - Country:US
Practice Address - Phone:440-816-2735
Practice Address - Fax:440-816-5306
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2803213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2700134OtherUNITED HEALTHCARE
OH34131419201OtherMEDICAL MUTUAL
OH000000130236OtherANTHEM
OH0970810Medicaid
OH54306OtherQUALCHOICE
OHF02803OtherSUMMA
OHF02803OtherSUMMA
OH0970810Medicaid