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General NPI Number Information
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NPI Number | 1528485018
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Entity Type | Organization
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Legal Business Name | PHILIP ZANETEAS, PHD, MD, INC., PC
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 03/24/2016
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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 | 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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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. BETTINA ZANETEAS
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Credential | MBA
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Telephone | 317-848-0800
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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 | 50003491A
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License Number State | IN
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