Healthcare Provider Details

I. General information

NPI: 1114041555
Provider Name (Legal Business Name): MICHAEL ZANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8643 SHERIDAN DR
WILLIAMSVILLE NY
14221-6315
US

IV. Provider business mailing address

8643 SHERIDAN DR
WILLIAMSVILLE NY
14221-6315
US

V. Phone/Fax

Practice location:
  • Phone: 716-565-9030
  • Fax:
Mailing address:
  • Phone: 716-565-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number253577
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: