Healthcare Provider Details

I. General information

NPI: 1104252998
Provider Name (Legal Business Name): LI ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON ROAD SUITE 1E50
NEWARK DE
19718-2200
US

IV. Provider business mailing address

3131 E CLARENDON AVE STE 102
PHOENIX AZ
85016-7069
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1980
  • Fax: 302-733-1986
Mailing address:
  • Phone: 602-253-9168
  • Fax: 602-251-3126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number277269
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number121762
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number59589
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberC1-0028196
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: