Provider Demographics
NPI:1093778847
Name:ZHANG, JIANYI (MD)
Entity Type:Individual
Prefix:DR
First Name:JIANYI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5816 WHITE PEBBLE PATH
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1664
Mailing Address - Country:US
Mailing Address - Phone:443-535-0280
Mailing Address - Fax:443-535-9664
Practice Address - Street 1:133 N ROYAL AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-2613
Practice Address - Country:US
Practice Address - Phone:540-636-8888
Practice Address - Fax:703-485-2970
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010582812083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG11870Medicare UPIN