Healthcare Provider Details

I. General information

NPI: 1770894354
Provider Name (Legal Business Name): DENG ZHANG MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 HARCOURT RD STE 200
INDIANAPOLIS IN
46260-2082
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-6600
  • Fax: 317-415-6649
Mailing address:
  • Phone: 239-432-8331
  • Fax: 813-321-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01083617A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number01083617A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: