Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01037652 | IN |
NPI | 1336258698 |
---|---|
Provider Name | Dawn Zimmer |
First Address | Indianapolis, IN 46260-1316 |
Second Address | Indianapolis, IN 46260-2495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 19/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100175940 | (05) | IN |
F02803 | (02) |