Provider Demographics
NPI:1760468268
Name:ZIMMERER, MICHAEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:ZIMMERER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1800
Mailing Address - Country:US
Mailing Address - Phone:740-454-4651
Mailing Address - Fax:740-454-4653
Practice Address - Street 1:1210 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2806
Practice Address - Country:US
Practice Address - Phone:740-454-8551
Practice Address - Fax:740-454-2411
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042303Z207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0377686Medicaid
OH080062380OtherMEDICARE RAILROAD PIN
CA1586OtherGROUP MEDICARE RAILROAD
OH000000177710OtherUNISON PIN
OH311413469033OtherCARESOURCE PIN
OH0111216OtherUHC PIN
OH000000019853OtherANTHEM PIN
OH0989499OtherGROUP MEDICAID
OH311413469033OtherCARESOURCE PIN
9270902Medicare PIN
OH000000177710OtherUNISON PIN
OH080062380OtherMEDICARE RAILROAD PIN
OH0377686Medicaid