Provider Demographics
NPI:1194774836
Name:ZIMMERMAN, STEVEN CARL (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CARL
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:349 FOLLY RD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2508
Mailing Address - Country:US
Mailing Address - Phone:843-795-8898
Mailing Address - Fax:843-795-8823
Practice Address - Street 1:349 FOLLY RD
Practice Address - Street 2:SUITE 2C
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2508
Practice Address - Country:US
Practice Address - Phone:843-795-8898
Practice Address - Fax:843-795-8823
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU691820281Medicare UPIN