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Individual

DR. KENNETH ZOUCHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
42ND @ DEWEY ST, OMAHA, NE 68198-1023
(402) 552-6007
(402) 552-6035
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
17958
NE
208000000X
Pediatrics Physician
Primary
17958
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34122
BLUE CROSS BLUE SHIELD NE
NE
05
F76234
NE
Enumeration date
08/15/2005
Last updated
12/05/2018
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