Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 036.133727 | IL |
Y | 2081P2900X | Pain Medicine | 2015028059 | MO |
NPI | 1184853152 |
---|---|
Provider Name | Tong Zhu |
First Address | Saint Louis, MO 63131 |
Second Address | Saint Louis, MO 63131-2930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2009 |
Last Update Date | 05/06/2020 |