Individual
STEPHEN EDWARD ZUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 MEMORIAL DR, SUITE 511, SOUTH BEND, IN 46601-1063
(574) 232-3919
(574) 233-1063
Mailing address
621 MEMORIAL DR, SUITE 511, SOUTH BEND, IN 46601-1063
(574) 232-3919
(574) 233-1063
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01034163
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224080
—
IN
Enumeration date
10/06/2006
Last updated
12/15/2009
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