Provider Demographics
NPI:1215227376
Name:BERRENS, ZACHARY J (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:J
Last Name:BERRENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-777-6435
Mailing Address - Fax:317-777-6644
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:RI 4900
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-948-7128
Practice Address - Fax:317-944-3442
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2021-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01078401207LC0200X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine