Provider Demographics
NPI:1164659645
Name:ZIMMERMAN, RYAN M (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1400 FRONT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5300
Mailing Address - Country:US
Mailing Address - Phone:410-296-6232
Mailing Address - Fax:410-821-5943
Practice Address - Street 1:1400 FRONT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5300
Practice Address - Country:US
Practice Address - Phone:410-296-6232
Practice Address - Fax:410-821-5943
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2023-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0079107207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH461Medicare PIN