Provider Demographics
NPI:1285627083
Name:ZHAO, FENG (MD)
Entity Type:Individual
Prefix:DR
First Name:FENG
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:962 JOE FRANK HARRIS PKWY SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2154
Mailing Address - Country:US
Mailing Address - Phone:770-382-3598
Mailing Address - Fax:770-382-4892
Practice Address - Street 1:962 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:SUITE 201
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2154
Practice Address - Country:US
Practice Address - Phone:770-382-3598
Practice Address - Fax:770-382-4892
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA050073207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00922985AMedicaid
H42186Medicare UPIN
18BDFXBMedicare ID - Type Unspecified