Provider Demographics
NPI:1043847221
Name:SIMAZ, ZOE MARIE (DPM)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:MARIE
Last Name:SIMAZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 WASHINGTON AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7724
Mailing Address - Country:US
Mailing Address - Phone:616-392-7472
Mailing Address - Fax:616-392-3327
Practice Address - Street 1:904 WASHINGTON AVE STE 130
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7724
Practice Address - Country:US
Practice Address - Phone:616-392-7472
Practice Address - Fax:616-392-3327
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901400486213E00000X
IN41000418A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist