Healthcare Provider Details

I. General information

NPI: 1275567067
Provider Name (Legal Business Name): XIAOQI SHERRIE ZHANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: XIAOQI SHERRIE ZHANG M.D.

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTH COVE COMMUNITY HEALTH CENTER 885 WASHINGTON STREET
BOSTON MA
02111
US

IV. Provider business mailing address

SOUTH COVE COMMUNITY HEALTH CENTER 885 WASHINGTON STREET
BOSTON MA
02111
US

V. Phone/Fax

Practice location:
  • Phone: 617-482-7555
  • Fax:
Mailing address:
  • Phone: 617-482-7555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number159726
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: