MEDICARE: WYLIE HUNG ZHU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	46914	MN
2	207T00000X	Neurological Surgery Physician	0101255217	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	46914	OTHER	MN	MN MEDICAL LICENSE

General Provider Information

NPI Number	:	1083692917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WYLIE HUNG ZHU MD

Provider Business Mailing Address
First Line	:	301 RIVERVIEW AVE STE 202A
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1065
Country	:	US
Telephone Number	:	757-252-9140
Fax Number	:	757-793-4149

Provider Business Practice Location Address
First Line	:	301 RIVERVIEW AVE STE 202A
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1065
Country	:	US
Telephone Number	:	757-252-9140
Fax Number	:	757-793-4149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	05/29/2024

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Directions to “ WYLIE HUNG ZHU MD” Practice Location

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