Healthcare Provider Details

I. General information

NPI: 1851825335
Provider Name (Legal Business Name): JUNE ZHAO GENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11220 ILLINOIS ST STE 220
CARMEL IN
46032-9847
US

IV. Provider business mailing address

PO BOX 637764
CINCINNATI OH
45263-7764
US

V. Phone/Fax

Practice location:
  • Phone: 317-817-1976
  • Fax: 317-817-1737
Mailing address:
  • Phone: 317-880-3939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number01089209A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: