Provider Demographics
NPI:1043382377
Name:ZHAO, AIQIU (LAC)
Entity Type:Individual
Prefix:
First Name:AIQIU
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14600 DEVEREAUX TER
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4331
Mailing Address - Country:US
Mailing Address - Phone:301-538-6368
Mailing Address - Fax:301-279-9271
Practice Address - Street 1:14600 DEVEREAUX TER
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-4331
Practice Address - Country:US
Practice Address - Phone:301-538-6368
Practice Address - Fax:301-279-9271
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01500171100000X
VA0121000438171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist