Provider Demographics
NPI:1962190983
Name:LEMUS ZAMORA, RICKY ERNESTO (MD)
Entity type:Individual
Prefix:MR
First Name:RICKY
Middle Name:ERNESTO
Last Name:LEMUS ZAMORA
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 1:1120 WEST MICHIGAN STREET, CL 630
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIST
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-278-2682
Mailing Address - Fax:
Practice Address - Street 1:1120 WEST MICHIGAN STREET, CL 630
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIST
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-278-2682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program