Healthcare Provider Details

I. General information

NPI: 1124236286
Provider Name (Legal Business Name): YUANJUE LOUANN ZHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11065 LITTLE PATUXENT PKWY
COLUMBIA MD
21044-2998
US

IV. Provider business mailing address

11065 LITTLE PATUXENT PKWY
COLUMBIA MD
21044-2998
US

V. Phone/Fax

Practice location:
  • Phone: 410-964-2212
  • Fax: 410-964-1111
Mailing address:
  • Phone: 410-964-2212
  • Fax: 410-964-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD0061624
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: