Provider Demographics
NPI:1851322218
Name:ZIMMERMAN, FREDRIC (DO)
Entity Type:Individual
Prefix:
First Name:FREDRIC
Middle Name:
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:PO BOX 271410
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-0024
Mailing Address - Country:US
Mailing Address - Phone:303-423-8334
Mailing Address - Fax:303-456-1856
Practice Address - Street 1:7821 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6109
Practice Address - Country:US
Practice Address - Phone:303-423-8334
Practice Address - Fax:303-456-1856
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43001208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43001OtherLICENSE
CO56982020Medicaid
CO800305Medicare ID - Type Unspecified