Healthcare Provider Details

I. General information

NPI: 1811028814
Provider Name (Legal Business Name): WEILAND ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E ST
SOUTH PORTLAND ME
04106-2811
US

IV. Provider business mailing address

65 E ST
SOUTH PORTLAND ME
04106-2811
US

V. Phone/Fax

Practice location:
  • Phone: 207-767-9868
  • Fax:
Mailing address:
  • Phone: 207-767-9868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 277
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: