MEDICARE: YIREN ZHU OMD

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	171100000X	Acupuncturist	1065	NC

General Provider Information

NPI Number	:	1295379683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YIREN ZHU OMD

Provider Business Mailing Address
First Line	:	6106 CAMISE LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27518-9300
Country	:	US
Telephone Number	:	919-522-5284
Fax Number	:

Provider Business Practice Location Address
First Line	:	7406 CHAPEL HILL RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5077
Country	:	US
Telephone Number	:	919-522-5284
Fax Number	:

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

Provider Enumeration Date	:	10/29/2019
Last Update Date	:	10/29/2019

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