Healthcare Provider Details

I. General information

NPI: 1497747364
Provider Name (Legal Business Name): ALEXANDER L ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 ROSEMARY DR
MANASSAS VA
20109-7282
US

IV. Provider business mailing address

10701 ROSEMARY DR
MANASSAS VA
20109-7282
US

V. Phone/Fax

Practice location:
  • Phone: 703-257-3000
  • Fax: 703-257-3057
Mailing address:
  • Phone: 703-257-3000
  • Fax: 703-257-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0062711
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD040935
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101248066
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: