Provider Demographics
NPI:1871565408
Name:ZIMMERMAN, TERRY JAY (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:JAY
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2370 E BIDWELL ST
Mailing Address - Street 2:#100
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3892
Mailing Address - Country:US
Mailing Address - Phone:916-983-0550
Mailing Address - Fax:916-983-0552
Practice Address - Street 1:2370 E BIDWELL ST
Practice Address - Street 2:#100
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3892
Practice Address - Country:US
Practice Address - Phone:916-983-0550
Practice Address - Fax:916-983-0552
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG0541732082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE90086Medicare UPIN