Provider Demographics
NPI:1881667772
Name:ZIMMERMAN, DAVID N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4532 TANBARK ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1654
Mailing Address - Country:US
Mailing Address - Phone:248-626-8733
Mailing Address - Fax:248-626-8734
Practice Address - Street 1:4532 TANBARK ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1654
Practice Address - Country:US
Practice Address - Phone:248-346-8100
Practice Address - Fax:248-626-8734
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI21562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist