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Individual

ZACHARY JOE MARANAR LESHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
611 E DOUGLAS RD, STE 208, MISHAWAKA, IN 46545-1464
(574) 335-6700
(574) 335-0726
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301092796
MI
207R00000X
Internal Medicine Physician
ML20008451
WA
207RC0000X
Cardiovascular Disease Physician
01072811A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01072811A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000824567
BCBS
IN
05
201180140
IN
Enumeration date
08/13/2006
Last updated
07/10/2023
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