Provider Demographics
NPI:1265438634
Name:ZIMMER, DANIEL V (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:V
Last Name:ZIMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BRANDT DR.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CRANBERRY TWP.
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6412
Mailing Address - Country:US
Mailing Address - Phone:724-772-5420
Mailing Address - Fax:724-772-5423
Practice Address - Street 1:105 BRANDT DR.
Practice Address - Street 2:SUITE 201
Practice Address - City:CRANBERRY TWP.
Practice Address - State:PA
Practice Address - Zip Code:16066-6412
Practice Address - Country:US
Practice Address - Phone:724-772-5420
Practice Address - Fax:724-772-5423
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050044L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000740507OtherAMERIHEALTH ADMINISTRATOR
PA000000092591OtherUNISON HEALTH PLAN
PA103105OtherUPMC HEALTH PLAN
PA0015779570007Medicaid
PA28628OtherADVANTRA/ HEALTH AMERICA
PAZI740507OtherUMWA
PA740507OtherHIGHMARK BCBS
PA1513104OtherGATEWAY HEALTH PLAN
PA180017416OtherRAILROAD MEDICARE
PA450883OtherAETNA
PA28628OtherADVANTRA/ HEALTH AMERICA
PA740507EVXMedicare PIN