Provider Demographics
NPI:1245337898
Name:ZIMMER, DEBRA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1478 ALMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-2520
Mailing Address - Country:US
Mailing Address - Phone:651-644-2646
Mailing Address - Fax:612-548-5903
Practice Address - Street 1:5101 MINNEHAHA AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-1647
Practice Address - Country:US
Practice Address - Phone:612-548-5977
Practice Address - Fax:612-548-5903
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2012-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN031172207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNVAD000Medicare UPIN