Provider Demographics
NPI:1033292131
Name:ZUCKER, MARJORIE L (MD)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:L
Last Name:ZUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 W 124 STREET
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209
Mailing Address - Country:US
Mailing Address - Phone:913-491-9287
Mailing Address - Fax:
Practice Address - Street 1:4401 WORNALL
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111
Practice Address - Country:US
Practice Address - Phone:816-932-3335
Practice Address - Fax:816-932-3822
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4350207ZP0102X
KS0417437207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E11416Medicare UPIN
17550867Medicare ID - Type Unspecified