Organization
BOONE PODIATRY PA
Active
Organization
BOONE PODIATRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ZIMMERMAN DPM (PODIATRIST/ OWNER)
(828) 265-3668
Entity
Organization
Contact information
Practice address
610 STATE FARM RD, STE C, BOONE, NC 28607-4738
(828) 265-3668
Mailing address
610 STATE FARM RD, STE C, BOONE, NC 28607-4738
(828) 265-3668
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
354
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
354
NC
213ES0131X
Foot Surgery Podiatrist
354
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0819K
BCBS
NC
05
—
890819K
—
NC
Enumeration date
06/10/2005
Last updated
09/21/2015
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