Healthcare Provider Details

I. General information

NPI: 1316982630
Provider Name (Legal Business Name): GAOYONG ZHU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 DURANT ST
SOUTH HILL VA
23970-1614
US

IV. Provider business mailing address

PO BOX 246 412 DURANT STREET
SOUTH HILL VA
23970-0246
US

V. Phone/Fax

Practice location:
  • Phone: 434-447-2898
  • Fax: 434-447-3456
Mailing address:
  • Phone: 434-447-2898
  • Fax: 434-447-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number207302
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number0101240696
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: