Provider Demographics
NPI:1538397658
Name:ZIMIK, ELCY (MD)
Entity type:Individual
Prefix:MRS
First Name:ELCY
Middle Name:
Last Name:ZIMIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17124 HIGHWAY 72 W
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:SC
Mailing Address - Zip Code:29384-5144
Mailing Address - Country:US
Mailing Address - Phone:864-393-1020
Mailing Address - Fax:864-393-1025
Practice Address - Street 1:17124 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:SC
Practice Address - Zip Code:29384-5144
Practice Address - Country:US
Practice Address - Phone:864-393-1020
Practice Address - Fax:864-393-1025
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35053207Q00000X
GA003795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine