Provider Demographics
NPI:1679579023
Name:ZIMMERMAN, JEFFREY M (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 CANTON ST
Mailing Address - Street 2:STE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 CANTON ST
Practice Address - Street 2:STE 2
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3524
Practice Address - Country:US
Practice Address - Phone:603-622-3623
Practice Address - Fax:603-625-5483
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH11946207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology