Healthcare Provider Details

I. General information

NPI: 1720373343
Provider Name (Legal Business Name): DR. JINZHU LI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2011
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1063
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-0140
  • Fax: 330-543-5207
Mailing address:
  • Phone: 330-543-0140
  • Fax: 330-543-5207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.097227
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number35.097227
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: