Provider Demographics
NPI:1295379683
Name:ZHU, YIREN (OMD)
Entity Type:Individual
Prefix:
First Name:YIREN
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 CAMISE LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9300
Mailing Address - Country:US
Mailing Address - Phone:919-522-5284
Mailing Address - Fax:
Practice Address - Street 1:7406 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5077
Practice Address - Country:US
Practice Address - Phone:919-522-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1065171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist