Provider Demographics
NPI:1104907153
Name:ZUKER, RONALD A (OD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:ZUKER
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 1:442 W WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1110
Mailing Address - Country:US
Mailing Address - Phone:231-722-3556
Mailing Address - Fax:231-726-6334
Practice Address - Street 1:442 W WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1110
Practice Address - Country:US
Practice Address - Phone:231-722-3556
Practice Address - Fax:231-726-6334
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002724152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1764557Medicaid
MI5082466Medicaid
MI1817089Medicaid
1033294350OtherNPI SHELBY
1831270891OtherNPI MUSKEGON
1942385265OtherNPI MONTAGUE
0F16038Medicare PIN
1033294350OtherNPI SHELBY
MI1764557Medicaid
0F16039Medicare PIN
MI1817089Medicaid