Provider Demographics
NPI:1134138530
Name:ZHU, WEIJIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WEIJIAN
Middle Name:
Last Name:ZHU
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 1:488 KENNESAW AVE NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-9409
Mailing Address - Country:US
Mailing Address - Phone:404-888-7575
Mailing Address - Fax:678-631-4624
Practice Address - Street 1:488 KENNESAW AVE NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9409
Practice Address - Country:US
Practice Address - Phone:404-888-7575
Practice Address - Fax:678-631-4624
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28549207ZC0500X, 207ZP0102X
GA057270207ZC0500X, 207ZP0102X
FL103245207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC28549OtherLICENSE
MI4301076449OtherLICENSE
GA057270OtherLICENSE
NC2006-00146OtherLICENSE
FLME103245OtherLICENSE