Provider Demographics
NPI:1669587564
Name:ZIMMERMAN, MARK W (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:W
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2417 ATRIUM DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6673
Mailing Address - Country:US
Mailing Address - Phone:919-781-9555
Mailing Address - Fax:919-781-1070
Practice Address - Street 1:2417 ATRIUM DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6673
Practice Address - Country:US
Practice Address - Phone:919-781-9555
Practice Address - Fax:919-781-1070
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC1104207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1199588OtherFIRST HEALTH
4558115OtherAETNA
1568182OtherCIGNA
A4026OtherMEDCOST
07-52523OtherUNITED HEALTHCARE
NC7989860Medicaid
NC89860OtherBCBS OF NC
NC89860OtherBCBS OF NC
07-52523OtherUNITED HEALTHCARE