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General NPI Number Information
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NPI Number | 1578927562
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Entity Type | Individual
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Provider Name | AIMEE Y ZHANG MD
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 98 POPLAR ST
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City | BLACKFOOT
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State | ID
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Zip | 83221-1799
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Country | US
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Telephone | 208-782-3993
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Fax |
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Provider Business Mailing Address
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Address Line | 124 W 210 N
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City | BLACKFOOT
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State | ID
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Zip | 83221-5812
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Country | US
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Telephone | 571-239-8315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35.148371
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4461777
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License Number State | ID
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