Individual
DR. LIESEL ZIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3412 W CENTRE AVE, PORTAGE, MI 49024
(269) 329-5860
Mailing address
3412 W CENTRE AVE, PORTAGE, MI 49024-4624
(269) 329-5860
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301105254
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301105254
MICHIGAN MEDICAL LICENSE NUMBER
MI
Enumeration date
06/23/2014
Last updated
05/29/2018
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