Healthcare Provider Details

I. General information

NPI: 1235005281
Provider Name (Legal Business Name): HANS HENK ZWART
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 W FRANKLIN ST
CENTERVILLE OH
45459-4762
US

IV. Provider business mailing address

1116 CLUB VIEW DR
CENTERVILLE OH
45458-6078
US

V. Phone/Fax

Practice location:
  • Phone: 937-433-9378
  • Fax:
Mailing address:
  • Phone: 702-556-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number35.036648
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: