Provider Demographics
NPI:1578528121
Name:OKIA, ZELDA IKULUMET (MD)
Entity Type:Individual
Prefix:DR
First Name:ZELDA
Middle Name:IKULUMET
Last Name:OKIA
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 1:515 W MORELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-2428
Mailing Address - Country:US
Mailing Address - Phone:262-548-7575
Mailing Address - Fax:262-896-8079
Practice Address - Street 1:515 W MORELAND BLVD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-2428
Practice Address - Country:US
Practice Address - Phone:262-548-7575
Practice Address - Fax:262-896-8079
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI42266207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32895800Medicaid
WI32895800Medicaid
WI32895800Medicaid