Healthcare Provider Details

I. General information

NPI: 1538077896
Provider Name (Legal Business Name): ROMAN ZUPIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 CITY CENTER DR
CARMEL IN
46032-3810
US

IV. Provider business mailing address

1260 CITY CENTER DR
CARMEL IN
46032-3810
US

V. Phone/Fax

Practice location:
  • Phone: 463-333-9110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05016552A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: