Healthcare Provider Details

I. General information

NPI: 1205821469
Provider Name (Legal Business Name): JOE SHUANGWEN ZHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 LAFAYETTE AVE
PALMERTON PA
18071-1518
US

IV. Provider business mailing address

169 DELAWARE AVE
PALMERTON PA
18071-1708
US

V. Phone/Fax

Practice location:
  • Phone: 610-824-2474
  • Fax: 610-826-7906
Mailing address:
  • Phone: 610-824-2474
  • Fax: 610-826-7906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD065452Y
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: