Provider Demographics
NPI:1891711370
Name:ZIMMERMAN, CATHERINE S (DO)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:S
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-2220
Mailing Address - Country:US
Mailing Address - Phone:231-627-7118
Mailing Address - Fax:
Practice Address - Street 1:740 S MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2220
Practice Address - Country:US
Practice Address - Phone:231-627-7118
Practice Address - Fax:231-627-1838
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0151600485OtherINDIVIDUAL BLUE CROSS
MI700A610010OtherGROUP BLUE CROSS
MI2846906Medicaid
F33357Medicare UPIN
MI700A610010OtherGROUP BLUE CROSS