Provider Demographics
NPI:1548758865
Name:ZGUNDA, GARRETT M (OD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:M
Last Name:ZGUNDA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4801 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5510
Mailing Address - Country:US
Mailing Address - Phone:765-288-7744
Mailing Address - Fax:765-282-0741
Practice Address - Street 1:4801 W BETHEL AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5510
Practice Address - Country:US
Practice Address - Phone:765-288-7744
Practice Address - Fax:765-282-0741
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004111A152W00000X
IN18004111B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist