Healthcare Provider Details

I. General information

NPI: 1376626374
Provider Name (Legal Business Name): HEATHER B GUTWEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6085 HEARTLAND DR STE 205
ZIONSVILLE IN
46077-4433
US

IV. Provider business mailing address

6085 HEARTLAND DR STE 205
ZIONSVILLE IN
46077-4433
US

V. Phone/Fax

Practice location:
  • Phone: 317-768-2200
  • Fax: 765-768-2209
Mailing address:
  • Phone: 317-768-2200
  • Fax: 765-768-2209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01040358
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01040358A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: