| Scott W. Zimostrad, Ph.d., P.c. | |
|
720 W Wackerly St Suite 12 Midland MI 48640-2769 | |
| (989) 839-6565 | |
| (989) 839-5794 |
| Full Name | Scott W. Zimostrad, Ph.d., P.c. |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 720 W Wackerly St, Midland, Michigan |
| Authorized Official Name and Position | Scott W Zimostrad (OWNER/ADMINISTRATOR) |
| Authorized Official Contact | 9898396565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott W. Zimostrad, Ph.d., P.c. 720 W Wackerly St Suite 12 Midland MI 48640-2769 Ph: (989) 839-6565 | Scott W. Zimostrad, Ph.d., P.c. 720 W Wackerly St Suite 12 Midland MI 48640-2769 Ph: (989) 839-6565 |
| NPI Number | 1578738514 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 04/29/2008 |
| Medicare PECOS PAC ID | 3274602958 |
|---|---|
| Medicare Enrollment ID | O20080521000256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578738514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | SZ630100 (Michigan) | Primary |
| Provider Name | Scott W Zimostrad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790722965 PECOS PAC ID: 8527098177 Enrollment ID: I20050815000305 |
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