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General NPI Number Information
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NPI Number | 1326091364
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Entity Type | Individual
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Provider Name | PHILIP DEAN ZANETEAS PH.D., M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 9240 N MERIDIAN ST SUITE 350
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1880
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Country | US
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Telephone | 317-848-0800
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Fax | 317-848-0804
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Provider Business Mailing Address
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Address Line | PO BOX 660264
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City | INDIANAPOLIS
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State | IN
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Zip | 46266-0264
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Country | US
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Telephone | 317-770-0055
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Fax | 317-770-0066
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01040424
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License Number State | IN
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