Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 223585 | MA |
NPI | 1013999754 |
---|---|
Provider Name | Dr. Meijuan Zhao |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 21/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2100941 | (05) | MA |
468194 | TUFTS HEALTH PLAN (01) | MA |
I36441 | (02) | |
J28567 | BCBS MA (01) | MA |