Provider Demographics
NPI:1164777629
Name:ZHAO, ZIBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIBIN
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:300 W COUNTRY CLUB RD STE 130
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5249
Mailing Address - Country:US
Mailing Address - Phone:575-625-2669
Mailing Address - Fax:575-624-4632
Practice Address - Street 1:300 W COUNTRY CLUB RD STE 130
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5249
Practice Address - Country:US
Practice Address - Phone:575-625-2669
Practice Address - Fax:575-624-4632
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0642207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery