Provider Demographics
NPI:1124138433
Name:ZIMMERMAN, ANNA M (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-242-3600
Mailing Address - Fax:812-242-3620
Practice Address - Street 1:1739 N 4TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4002
Practice Address - Country:US
Practice Address - Phone:812-242-3600
Practice Address - Fax:812-242-3620
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032391A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000089627OtherANTHEM
IN100243800Medicaid
INP00834685OtherRAILROAD MEDICARE
080051424OtherRAILROAD MCARE PALAMETTO
IN192770WWWMedicare PIN
IN100243800Medicaid
INP00834685OtherRAILROAD MEDICARE
080051424OtherRAILROAD MCARE PALAMETTO
IN265130QMedicare PIN