Individual
ANDREW W ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, PEDIATRIC NEUROLOGY, WORCESTER, MA 01655-0002
(774) 442-5695
(508) 856-4287
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
216753
MA
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
216753
MA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
216753
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110033314A
—
MA
01
—
S400104406
MEDICARE
MA
Enumeration date
05/03/2006
Last updated
05/25/2017
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