Healthcare Provider Details

I. General information

NPI: 1194083659
Provider Name (Legal Business Name): ZHENGTONG PEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4831 TESLA DR STE F
BOWIE MD
20715
US

IV. Provider business mailing address

12510 PROSPERITY DR STE 200
SILVER SPRING MD
20904-1640
US

V. Phone/Fax

Practice location:
  • Phone: 240-737-0080
  • Fax: 301-464-2783
Mailing address:
  • Phone: 240-485-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD0085300
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: