Healthcare Provider Details

I. General information

NPI: 1780205625
Provider Name (Legal Business Name): SIBO ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HUNTINGDON PIKE
ROCKLEDGE PA
19046-4431
US

IV. Provider business mailing address

PO BOX 788735
PHILADELPHIA PA
19178-8735
US

V. Phone/Fax

Practice location:
  • Phone: 215-780-2000
  • Fax: 215-780-2007
Mailing address:
  • Phone: 215-456-7000
  • Fax: 215-254-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD481984
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: