Provider Demographics
NPI:1215974894
Name:ZIMMERMAN, JOHN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:ZIMMERMAN
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 1:301 OCEAN VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1269
Mailing Address - Country:US
Mailing Address - Phone:410-548-2343
Mailing Address - Fax:844-332-3891
Practice Address - Street 1:301 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1269
Practice Address - Country:US
Practice Address - Phone:410-548-2343
Practice Address - Fax:844-332-3891
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD83821207R00000X
VA0101233779207R00000X
DEC1-0012226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA465493OtherANTHEM
VA4478445OtherAETNA
VA325908OtherSOUTHERN HEALTH
VA1215974894Medicaid
VA1060654OtherCIGNA
VA110248478OtherRAILROAD MEDICARE
VA1060654OtherCIGNA
VA1215974894Medicaid