Healthcare Provider Details

I. General information

NPI: 1114372273
Provider Name (Legal Business Name): CHI ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 MEDICAL CENTER BLVD STE 200
LAWRENCEVILLE GA
30046-7765
US

IV. Provider business mailing address

2200 MEDICAL CENTER BLVD STE 200
LAWRENCEVILLE GA
30046-7765
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-1000
  • Fax:
Mailing address:
  • Phone: 678-312-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number99704
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number99704
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: