Healthcare Provider Details

I. General information

NPI: 1609052752
Provider Name (Legal Business Name): XIAOLAN ZHU PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 09/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3613 CHAIN BRIDGE RD SUITE A
FAIRFAX VA
22030-3238
US

IV. Provider business mailing address

3613 CHAIN BRIDGE RD SUITE A
FAIRFAX VA
22030-3238
US

V. Phone/Fax

Practice location:
  • Phone: 703-893-6680
  • Fax: 703-896-6676
Mailing address:
  • Phone: 703-893-6680
  • Fax: 703-896-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101232556
License Number StateVA

VIII. Authorized Official

Name: DR. XIAOLAN ZHU
Title or Position: OWNER
Credential: MD
Phone: 703-893-6680