Provider Demographics
NPI:1184625261
Name:ZALOGA, GARY P (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:P
Last Name:ZALOGA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6640 PARKDALE PL
Mailing Address - Street 2:SUITE T
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5619
Mailing Address - Country:US
Mailing Address - Phone:317-280-2200
Mailing Address - Fax:317-280-2212
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-962-5820
Practice Address - Fax:317-962-3916
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01054594A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN165460YMedicare ID - Type Unspecified
INC87341Medicare UPIN