Provider Demographics
NPI:1083611446
Name:ZENG, JIANFENG (MD)
Entity Type:Individual
Prefix:
First Name:JIANFENG
Middle Name:
Last Name:ZENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2100
Mailing Address - Country:US
Mailing Address - Phone:910-671-0407
Mailing Address - Fax:910-671-0570
Practice Address - Street 1:4850 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2100
Practice Address - Country:US
Practice Address - Phone:910-671-0407
Practice Address - Fax:910-671-0570
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129RWMedicaid
H47910Medicare UPIN
NC89129RWMedicaid