Provider Demographics
NPI:1447329826
Name:ZUNICA, THOMAS WAYNE (DPM)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WAYNE
Last Name:ZUNICA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3901 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3113
Mailing Address - Country:US
Mailing Address - Phone:317-221-3584
Mailing Address - Fax:317-221-5771
Practice Address - Street 1:3901 MEADOWS DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-3113
Practice Address - Country:US
Practice Address - Phone:317-221-3584
Practice Address - Fax:317-221-5771
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000610A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100066900Medicaid
IN4198060001Medicare NSC
INU25857Medicare UPIN
IN100066900Medicaid