Basic Information
Provider Information
NPI: 1205888591
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHU
FirstName: YAO-YAO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7175 MOORLAND DR
Address2:  
City: CLARKSVILLE
State: MD
PostalCode: 210291734
CountryCode: US
TelephoneNumber: 3018542671
FaxNumber:  
Practice Location
Address1: 6565 N CHARLES ST
Address2: SUITE 203
City: BALTIMORE
State: MD
PostalCode: 212046800
CountryCode: US
TelephoneNumber: 4438493760
FaxNumber: 4438498138
Other Information
ProviderEnumerationDate: 05/16/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XD53654MDY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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