Provider Demographics
NPI:1104979970
Name:ZIMMERMAN, RAYMOND JOHN III (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOHN
Last Name:ZIMMERMAN
Suffix:III
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 425
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-9221
Mailing Address - Country:US
Mailing Address - Phone:814-944-4770
Mailing Address - Fax:
Practice Address - Street 1:RR 3 BOX 425
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9221
Practice Address - Country:US
Practice Address - Phone:814-944-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043437E2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine