Healthcare Provider Details

I. General information

NPI: 1396870887
Provider Name (Legal Business Name): KARA ZIMMERMAN, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11650 LANTERN RD SUITE 209
FISHERS IN
46038-2993
US

IV. Provider business mailing address

250 BREAKWATER DR
FISHERS IN
46037-9506
US

V. Phone/Fax

Practice location:
  • Phone: 317-439-4111
  • Fax:
Mailing address:
  • Phone: 317-842-7397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01047165
License Number StateIN

VIII. Authorized Official

Name: DR. KARA ZIMMERMAN HWANG
Title or Position: OWNER PHYSICIAN
Credential: M.D.
Phone: 317-439-4111