Healthcare Provider Details

I. General information

NPI: 1700977212
Provider Name (Legal Business Name): WEI ZHOU D.O.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 PENNSYLVANIA CIR NE SUITE A
ALBUQUERQUE NM
87110-7827
US

IV. Provider business mailing address

7900 PENNSYLVANIA CIR NE SUITE A
ALBUQUERQUE NM
87110-7827
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-5168
  • Fax: 505-265-5168
Mailing address:
  • Phone: 505-265-5168
  • Fax: 505-265-5168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number419
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: