Provider Demographics
NPI:1760471155
Name:ZIMMERMANN, MAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAJA
Middle Name:
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WEYBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1060
Mailing Address - Country:US
Mailing Address - Phone:802-388-0921
Mailing Address - Fax:
Practice Address - Street 1:124 WEYBRIDGE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1060
Practice Address - Country:US
Practice Address - Phone:802-388-0921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420006426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0007993Medicaid
VN0442Medicare ID - Type Unspecified
B85450Medicare UPIN