Provider Demographics
NPI:1891018065
Name:ZIMMERMAN, CHRISTOPHER MARTIN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARTIN
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-3213
Mailing Address - Country:US
Mailing Address - Phone:617-822-5530
Mailing Address - Fax:617-265-4193
Practice Address - Street 1:632 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-3213
Practice Address - Country:US
Practice Address - Phone:617-822-5530
Practice Address - Fax:617-265-4193
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79623207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics