Provider Demographics
NPI:1225355613
Name:ZELASKO, MARGARET R (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:ZELASKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:R
Other - Last Name:DEMOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1910 W ROYALE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2264
Mailing Address - Country:US
Mailing Address - Phone:765-289-1011
Mailing Address - Fax:
Practice Address - Street 1:1910 W ROYALE DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2264
Practice Address - Country:US
Practice Address - Phone:765-289-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01073466A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine