Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 11019712A | IN |
NPI | 1215440334 |
---|---|
Provider Name | Matthieu Zingg |
First Address | Indianapolis, IN 46205-2602 |
Second Address | Fishers, IN 46037-9478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2017 |
Last Update Date | 10/11/2017 |