Provider Demographics
NPI:1225060791
Name:ZHOU, SHAN-REN (MD)
Entity Type:Individual
Prefix:
First Name:SHAN-REN
Middle Name:
Last Name:ZHOU
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 1:5651 FRIST BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2054
Mailing Address - Country:US
Mailing Address - Phone:615-391-8160
Mailing Address - Fax:615-391-9086
Practice Address - Street 1:5651 FRIST BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2054
Practice Address - Country:US
Practice Address - Phone:615-391-8160
Practice Address - Fax:615-391-9086
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30538174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG88910Medicare UPIN
TN3835787Medicare ID - Type Unspecified