Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Zeyn T. Mirza

Individual provider Internal Medicine Physician · NPI 1578095717

Dr. Zeyn T. Mirza is a Gastroenterology in Newark, Ohio. Qualified in 2017, 9 years ago. Practices with Licking Memorial Professional Corporation, a 235-clinician group and accepts Medicare assignment. Licensed in Ohio and Puerto Rico.

Years since qualifying
9
Licensed in
OH, PR
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1717 W Main St Ste 203
Newark, OH 43055-5343
Phone: (220) 564-2950
Fax: (220) 564-2951
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 35.148279 (OH)
Internal Medicine Physician Taxonomy 207R00000X · Licence 21732 (PR)

Record details

NPI number1578095717
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 28, 2017
Last updated in NPPESSeptember 15, 2023
Certification dateSeptember 15, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Licking Memorial Professional Corporation — 235 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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