Healthcare Provider Details

I. General information

NPI: 1063649101
Provider Name (Legal Business Name): SIMEON ZOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MARY ST
EVANSVILLE IN
47710-1658
US

IV. Provider business mailing address

600 MARY ST
EVANSVILLE IN
47710-1658
US

V. Phone/Fax

Practice location:
  • Phone: 269-330-5631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301102180
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2009010335
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301102180
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01088913A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: