Healthcare Provider Details

I. General information

NPI: 1962422022
Provider Name (Legal Business Name): QINGYAN ZHU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERRY ZHU M.D.

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15154 CARROLLTON BLVD SUITE A
CARROLLTON VA
23314-2316
US

IV. Provider business mailing address

15154 CARROLLTON BLVD SUITE A
CARROLLTON VA
23314-2316
US

V. Phone/Fax

Practice location:
  • Phone: 757-745-7555
  • Fax: 757-745-7560
Mailing address:
  • Phone: 757-745-7555
  • Fax: 757-745-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101229252
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: