Provider Demographics
NPI:1033301767
Name:TCHAMAKE-ZUCK, MARIE-MADELEIN N
Entity Type:Individual
Prefix:MRS
First Name:MARIE-MADELEIN
Middle Name:N
Last Name:TCHAMAKE-ZUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 WAYCROSS RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3936
Mailing Address - Country:US
Mailing Address - Phone:513-742-0059
Mailing Address - Fax:
Practice Address - Street 1:546 WAYCROSS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3936
Practice Address - Country:US
Practice Address - Phone:513-742-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH325334163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice