Provider Demographics
NPI:1043330012
Name:ZHANG, DEKUI (MD)
Entity type:Individual
Prefix:DR
First Name:DEKUI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 WEST PRESIDENTIAL WAY
Mailing Address - Street 2:SUITE H
Mailing Address - City:EDINGBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124
Mailing Address - Country:US
Mailing Address - Phone:812-348-4000
Mailing Address - Fax:
Practice Address - Street 1:2400 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5351
Practice Address - Country:US
Practice Address - Phone:812-373-3024
Practice Address - Fax:812-376-0678
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064890A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000991121OtherANTHEM PIN
IN200953940Medicaid
000000991121OtherANTHEM PIN