Provider Demographics
NPI:1932161528
Name:ZEUCH, DAVID N (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:ZEUCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 PORTLAND WAY N
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-1631
Mailing Address - Country:US
Mailing Address - Phone:419-468-3545
Mailing Address - Fax:419-468-3545
Practice Address - Street 1:218 PORTLAND WAY N
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-1631
Practice Address - Country:US
Practice Address - Phone:419-468-3545
Practice Address - Fax:419-468-3545
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3758/T714152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0565026Medicaid
P00076784Medicare PIN
4998260002Medicare NSC
OHT48075Medicare UPIN
0552709Medicare PIN
4998260001Medicare NSC
0552708Medicare PIN