Healthcare Provider Details

I. General information

NPI: 1154703122
Provider Name (Legal Business Name): FENG ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E HAMPDEN AVE SUITE 310
ENGLEWOOD CO
80113-3781
US

IV. Provider business mailing address

PO BOX 12330
AUGUSTA GA
30914-2330
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-9595
  • Fax: 888-745-3917
Mailing address:
  • Phone: 706-863-9595
  • Fax: 888-745-3917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA.0001988
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: