Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 0101255217 | VA |
N | 207T00000X | Neurosurgeon | 46914 | MN |
NPI | 1083692917 |
---|---|
Provider Name | Wylie H Zhu |
First Address | Norfolk, VA 23510-1065 |
Second Address | Norfolk, VA 23510-1065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 24/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46914 | MN MEDICAL LICENSE (01) | MN |