Basic Information
| Provider Information | |||||||||
| NPI: | 1720286594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHANG | ||||||||
| FirstName: | WENQING | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 102222 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303682222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845034500 | ||||||||
| FaxNumber: | 4845034501 | ||||||||
| Practice Location | |||||||||
| Address1: | 521 N LECANTO HWY | ||||||||
| Address2: | |||||||||
| City: | LECANTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344619187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527460707 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2007 | ||||||||
| LastUpdateDate: | 09/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 53924 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | ME149474 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0000X | 53924 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0003X | 036128381 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RX0202X | MD00000 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RX0202X | 53924 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RX0202X | ME149474 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 114513500 | 05 | FL | MEDICAID |