Healthcare Provider Details

I. General information

NPI: 1083665384
Provider Name (Legal Business Name): XIANFENG ZHU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/27/2023
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 SOUTHPOINTE DR SUITE B
INDIANAPOLIS IN
46227-7509
US

IV. Provider business mailing address

6626 E. 75TH STREET SUITE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-497-1900
  • Fax: 317-497-1919
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36607
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: