Healthcare Provider Details

I. General information

NPI: 1407226889
Provider Name (Legal Business Name): MARC ZHANG DNP, MD(ECFMG-C), MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5632 ANNAPOLIS RD STE 4
BLADENSBURG MD
20710-2213
US

IV. Provider business mailing address

13623 BALTIMORE AVE
LAUREL MD
20707-5095
US

V. Phone/Fax

Practice location:
  • Phone: 301-851-5766
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN1045164
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR221543
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: