Healthcare Provider Details

I. General information

NPI: 1083146294
Provider Name (Legal Business Name): FAN ZHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 UNION ST
MARLBOROUGH MA
01752-1228
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-486-6780
  • Fax: 774-843-7367
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number1027346
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: