Provider Demographics
NPI:1932303708
Name:ZIMMERMAN, ANNE CHRISTINA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:CHRISTINA
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 1:22 BOZARD ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-2935
Mailing Address - Country:US
Mailing Address - Phone:803-435-8828
Mailing Address - Fax:803-435-2239
Practice Address - Street 1:22 BOZARD ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102
Practice Address - Country:US
Practice Address - Phone:803-435-8828
Practice Address - Fax:803-435-2239
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70612207Q00000X
ORDO153324207Q00000X
WAOP60048337207Q00000X
TXM5928207Q00000X
SC36190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGA1539Medicaid