Provider Demographics
NPI:1972604742
Name:ZIEM, GRACE EDITH (MD MPH MS DRPH)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:EDITH
Last Name:ZIEM
Suffix:
Gender:F
Credentials:MD MPH MS DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16926 EYLERS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:EMMITSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21727-9729
Mailing Address - Country:US
Mailing Address - Phone:301-241-4347
Mailing Address - Fax:301-241-4348
Practice Address - Street 1:16926 EYLERS VALLEY RD
Practice Address - Street 2:
Practice Address - City:EMMITSBURG
Practice Address - State:MD
Practice Address - Zip Code:21727-9729
Practice Address - Country:US
Practice Address - Phone:301-241-4347
Practice Address - Fax:301-241-4348
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018732207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
9546Medicare ID - Type Unspecified
B69874Medicare UPIN