Provider Demographics
NPI:1922201870
Name:ZHUK, STANISLAV A (MD)
Entity Type:Individual
Prefix:DR
First Name:STANISLAV
Middle Name:A
Last Name:ZHUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 HOUMA BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2940
Mailing Address - Country:US
Mailing Address - Phone:504-456-9061
Mailing Address - Fax:504-888-6045
Practice Address - Street 1:4315 HOUMA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2940
Practice Address - Country:US
Practice Address - Phone:504-456-9061
Practice Address - Fax:504-888-6045
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.202985207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2139339Medicaid
LA4Q6286637Medicare PIN