Healthcare Provider Details

I. General information

NPI: 1952725384
Provider Name (Legal Business Name): ANGELA ZENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 AMERICAN AVE
WAUKESHA WI
53188-5031
US

IV. Provider business mailing address

725 AMERICAN AVE
WAUKESHA WI
53188-5099
US

V. Phone/Fax

Practice location:
  • Phone: 262-928-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number68591
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: