Provider Demographics
NPI:1083794168
Name:TAUSCHER, ZENAIDA REYES (MD)
Entity Type:Individual
Prefix:DR
First Name:ZENAIDA
Middle Name:REYES
Last Name:TAUSCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ZENAIDA
Other - Middle Name:CHIONG
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8111 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2479
Mailing Address - Country:US
Mailing Address - Phone:317-415-7921
Mailing Address - Fax:317-415-7922
Practice Address - Street 1:8111 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2479
Practice Address - Country:US
Practice Address - Phone:317-415-7921
Practice Address - Fax:317-415-7922
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059619A2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000393537OtherANTHEM BCBS
IN200525390AMedicaid