# ZORMEIER COSMETIC SURGERY AND LONGEVITY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104120104
- **Authorized official:** DR. MICHELE M ZORMEIER MD (PRINCIPAL)
- **Authorized official phone:** (317) 392-6200

## Contact information

- **Practice address:** 302 DURAN DR, SHELBYVILLE, IN 46176-1986
- **Practice address phone:** (317) 392-6200
- **Practice address fax:** (317) 398-7526
- **Mailing address:** 302 DURAN DR, SHELBYVILLE, IN 46176-1986
- **Mailing address phone:** (317) 392-6200
- **Mailing address fax:** (317) 398-7526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 01050761A | IN | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 01050761A | IN | Yes |

## Other

- **Enumeration date:** 01/05/2011
- **Last updated:** 01/05/2011