Zack, Debra A

Zack, Debra A is an individual health care provider with primary practice located at 200 Alfred St , Michigan City IN 46360. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Zack, Debra A can be contacted via phone (219) 872-6200.

Contact Information

Primary practice address
200 Alfred St Michigan City IN 46360
Phone: (219) 872-6200
Fax: (219) 879-2915
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001389 Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001389A Indiana

Profile Details

NPI number 1750362901
LBN Legal business name Zack, Debra A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Mar 12th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750362901 NPPES
Indiana MEDICAID 100366040

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