Basic Information
| Provider Information | |||||||||
| NPI: | 1538304035 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHANG | ||||||||
| FirstName: | YUYANG | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7253 AMBASSADOR ROAD | ||||||||
| Address2: | CREDENTIALING DEPARTMENT | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212442710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434361221 | ||||||||
| FaxNumber: | 4434361256 | ||||||||
| Practice Location | |||||||||
| Address1: | 1209 YORK RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210936208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105802240 | ||||||||
| FaxNumber: | 4434361256 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207U00000X | MD60349226 | WA | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | 2085R0202X | D0083230 | MD | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 7262 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 207U00000X | D0083230 | MD | Y | Allopathic & Osteopathic Physicians | Nuclear Medicine |
ID Information
| ID | Type | State | Issuer | Description | 121695300 | 05 | MD | MEDICAID | 1538304035 | 05 | WA | MEDICAID |