Basic Information
| Provider Information | |||||||||
| NPI: | 1215420005 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHEN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | YANBO | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3131 NEWMARK DR STE 220 | ||||||||
| Address2: | |||||||||
| City: | MIAMISBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453425400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374388910 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 OAKLAND DR | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490081282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693376600 | ||||||||
| FaxNumber: | 2693376475 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2018 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5101025402 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 390200000X | 5101025402 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | 5151011535 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 34.014938 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.