Provider Demographics
NPI:1386734184
Name:ZWEMER, DOUGLAS A (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:ZWEMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1745 HOLTON RD STE C
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-1453
Mailing Address - Country:US
Mailing Address - Phone:317-479-9902
Mailing Address - Fax:855-761-1953
Practice Address - Street 1:1745 HOLTON RD STE C
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-1453
Practice Address - Country:US
Practice Address - Phone:231-747-9902
Practice Address - Fax:855-761-1953
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2020-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MID2061383208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3453681Medicaid
MI0M57840Medicare PIN
G82340Medicare UPIN