Provider Demographics
NPI:1689654204
Name:ZUNICH, JANICE (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:ZUNICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:ZUNICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:COMMUNITY DIAGNOSTIC CENTER
Mailing Address - Street 2:10020 DONALD POWERS DR.
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-934-8856
Mailing Address - Fax:219-934-8870
Practice Address - Street 1:COMMUNITY DIAGNOSTIC CENTER
Practice Address - Street 2:10020 DONALD POWERS DR.
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-934-8856
Practice Address - Fax:219-934-8870
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034266A207SC0300X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Cytogenetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100339170AMedicaid
IN100339170AMedicaid
IN982900Medicare PIN
IN705110Medicare PIN