Healthcare Provider Details

I. General information

NPI: 1558866210
Provider Name (Legal Business Name): MENGMENG ZHENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE. ML 5030
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

4208 SHETLAND CT
NEW ALBANY IN
47150-9692
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4251
  • Fax: 513-636-8145
Mailing address:
  • Phone: 812-989-2942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number59589
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number35.150478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: