Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD0426455 | PA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | D73148 | MD |
NPI | 1366556185 |
---|---|
Provider Name | Yong Tao Zheng |
First Address | Belfast, ME 04915-4017 |
Second Address | Annapolis, MD 21401-7992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 01/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01472133 | AMERIGROUP (01) | |
048504700 | (05) | MD |
256538 | JHHC (01) | |
7553448 | AETNA PPO (01) | |
N4350008 | BCBS (01) |