Healthcare Provider Details

I. General information

NPI: 1265448856
Provider Name (Legal Business Name): ZHONGREN ZHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S EUCLID AVE
SAINT LOUIS MO
63110-1005
US

IV. Provider business mailing address

660 S EUCLID AVE C B 8118
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-273-1884
  • Fax: 314-362-0369
Mailing address:
  • Phone: 314-273-1884
  • Fax: 314-362-0369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number2017044463
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: