MEDICARE: MAOCHENG ZHAN 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	207R00000X	Internal Medicine Physician	MD. 203022	LA

General Provider Information

NPI Number	:	1548413172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAOCHENG ZHAN MD

Provider Business Mailing Address
First Line	:	524 DR. MICHAEL DEBAKEY DRIVE
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-0000
Country	:	US
Telephone Number	:	337-430-4455
Fax Number	:	337-430-4454

Provider Business Practice Location Address
First Line	:	524 DR MICHAEL DEBAKEY DRIVE
Second Line	:	ST PATRICK HOSOITAL
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-0000
Country	:	US
Telephone Number	:	337-430-4455
Fax Number	:	337-430-4454

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

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	11/02/2010

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