Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 206169 | LA |
NPI | 1013174143 |
---|---|
Provider Name | Peimin Zhu |
First Address | Shreveport, LA 71105-5741 |
Second Address | Shreveport, LA 71105-5741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 16/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1064670 | (05) | LA |
301327YH54 | MEDICARE - PTAN (01) | LA |