Healthcare Provider Details

I. General information

NPI: 1144807272
Provider Name (Legal Business Name): CASEY ZEUNIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASEY MILLER MD

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD # UH3005
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

550 UNIVERSITY BLVD STE 3005
INDIANAPOLIS IN
46202-5149
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-2167
  • Fax: 317-944-2305
Mailing address:
  • Phone: 317-944-2167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01093252A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: