Basic Information
Provider Information
NPI: 1912438243
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIEHL
FirstName: ZACHARY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 11109 PARKVIEW PLAZA DR # 117
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468451701
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 11143 PARKVIEW PLAZA DR STE 207
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468451728
CountryCode: US
TelephoneNumber: 2602665370
FaxNumber: 2602665379
Other Information
ProviderEnumerationDate: 03/27/2017
LastUpdateDate: 10/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X70045-20WIN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X01087290AINY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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