Healthcare Provider Details

I. General information

NPI: 1225060791
Provider Name (Legal Business Name): SHAN-REN ZHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BLVD SUITE 308
HERMITAGE TN
37076-2054
US

IV. Provider business mailing address

5651 FRIST BLVD SUITE 308
HERMITAGE TN
37076-2054
US

V. Phone/Fax

Practice location:
  • Phone: 615-391-8160
  • Fax: 615-391-9086
Mailing address:
  • Phone: 615-391-8160
  • Fax: 615-391-9086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number30538
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: