Healthcare Provider Details

I. General information

NPI: 1932495074
Provider Name (Legal Business Name): CHENGSHUI ZHAO M.D., PH D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 UNIVERSITY BLVD
BIRMINGHAM AL
35294-1010
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number36011
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: