Healthcare Provider Details

I. General information

NPI: 1801630751
Provider Name (Legal Business Name): NAN ZHANG L.AC, PHD, BM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 N HIGH ST
COLUMBUS OH
43214-3527
US

IV. Provider business mailing address

3800 N HIGH ST
COLUMBUS OH
43214-3527
US

V. Phone/Fax

Practice location:
  • Phone: 614-267-3800
  • Fax: 614-947-0358
Mailing address:
  • Phone: 614-267-3800
  • Fax: 614-947-0358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: