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Individual

DR. SCOTT WILLIAM ZIMOSTRAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
728 W WACKERLY ST, SUITE 1, MIDLAND, MI 48640-4703
(989) 839-6565
(989) 839-5794
Mailing address
728 W WACKERLY ST, SUITE 1, MIDLAND, MI 48640-4703
(989) 839-6565
(989) 839-5794

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301004028
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E64565
BCBS OF MICHIGAN
MI
Enumeration date
05/31/2006
Last updated
07/08/2007
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