Basic Information
Provider Information
NPI: 1427321124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHANG
FirstName: SHUANG
MiddleName: YIN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ZHANG
OtherFirstName: SHUANGYIN
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 531 ROSELANE STREET
Address2: SUITE 710
City: MARIETTA
State: GA
PostalCode: 300606975
CountryCode: US
TelephoneNumber: 6783313297
FaxNumber: 6785817187
Practice Location
Address1: 340 KENNESTONE HOSPITAL BLVD
Address2: SUITE 200
City: MARIETTA
State: GA
PostalCode: 300601173
CountryCode: US
TelephoneNumber: 7702815100
FaxNumber: 6785817100
Other Information
ProviderEnumerationDate: 02/12/2012
LastUpdateDate: 12/13/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X075569GAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
142732112401GANPI NUMBEROTHER


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