Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 20970 | MD |
Y | 2251X0800X | Physical Therapist - Orthopedic | 20970 | MD |
NPI | 1447257761 |
---|---|
Provider Name | Cameron L Zimmer |
First Address | Lutherville, MD 21093-6240 |
Second Address | Lutherville, MD 21093-6240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 06/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
074737800 | (05) | MD |
3115837 | MAMSI (01) | MD |