Healthcare Provider Details

I. General information

NPI: 1780755868
Provider Name (Legal Business Name): WEIGANG ZHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 MILLPARK DR
MARYLAND HEIGHTS MO
63043-3530
US

IV. Provider business mailing address

2326 MILLPARK DR
MARYLAND HEIGHTS MO
63043-3530
US

V. Phone/Fax

Practice location:
  • Phone: 314-991-4313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2002004672
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: