Healthcare Provider Details

I. General information

NPI: 1891845632
Provider Name (Legal Business Name): ZHAOLI LANE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZHAOLI LANE M.D.

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREEN VALLEY RD SUITE 104
GREENSBORO NC
27408-7038
US

IV. Provider business mailing address

900 DOVER RD
GREENSBORO NC
27408-7310
US

V. Phone/Fax

Practice location:
  • Phone: 336-387-2500
  • Fax:
Mailing address:
  • Phone: 313-585-8968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number142531
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: