Provider Demographics
NPI:1417230178
Name:ZWILLING, SHAWN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:ZWILLING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3734 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-1456
Mailing Address - Country:US
Mailing Address - Phone:317-545-6167
Mailing Address - Fax:317-562-1885
Practice Address - Street 1:3734 E 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-1456
Practice Address - Country:US
Practice Address - Phone:317-545-6167
Practice Address - Fax:317-562-1885
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022800A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist