Healthcare Provider Details

I. General information

NPI: 1578587440
Provider Name (Legal Business Name): YING MING ZHANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 S BERKELEY LAKE RD
NORCROSS GA
30071-1660
US

IV. Provider business mailing address

4530 S BERKELEY LAKE RD STE B
BERKELEY LAKE GA
30071-1657
US

V. Phone/Fax

Practice location:
  • Phone: 770-446-5642
  • Fax: 770-446-5643
Mailing address:
  • Phone: 770-446-5642
  • Fax: 770-446-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number058247
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: