Provider Demographics
NPI:1992594923
Name:DIRR, ZACHARY MICHAEL
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:MICHAEL
Last Name:DIRR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10621 E EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-1962
Mailing Address - Country:US
Mailing Address - Phone:765-499-1005
Mailing Address - Fax:765-499-1005
Practice Address - Street 1:10621 E EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-1962
Practice Address - Country:US
Practice Address - Phone:765-499-1005
Practice Address - Fax:765-499-1005
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service