Basic Information
Provider Information
NPI: 1942689674
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHOU-TALBERT
FirstName: SERENA
MiddleName: SHUNAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D., MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 439 US HIGHWAY 158 W
Address2:  
City: YANCEYVILLE
State: NC
PostalCode: 273798304
CountryCode: US
TelephoneNumber: 3366949331
FaxNumber:  
Practice Location
Address1: 439 US HIGHWAY 158 W
Address2:  
City: YANCEYVILLE
State: NC
PostalCode: 27379
CountryCode: US
TelephoneNumber: 3366949331
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/27/2015
LastUpdateDate: 05/30/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X2018-01259NCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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