Provider Demographics
NPI:1881611556
Name:ZIMNOCH, LAWRENCE A (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:ZIMNOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 M ST NW STE 302
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1468
Mailing Address - Country:US
Mailing Address - Phone:202-296-0043
Mailing Address - Fax:202-296-1306
Practice Address - Street 1:2311 M ST NW STE 302
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1468
Practice Address - Country:US
Practice Address - Phone:202-296-0043
Practice Address - Fax:202-296-1306
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 16729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF06043Medicare UPIN
DC609043Medicare ID - Type UnspecifiedMEDICARE NUMBER