Provider Demographics
NPI:1386837615
Name:ZHOU, FAN
Entity Type:Individual
Prefix:DR
First Name:FAN
Middle Name:
Last Name:ZHOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4796 OLD TAR RD
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9752
Mailing Address - Country:US
Mailing Address - Phone:252-353-4111
Mailing Address - Fax:252-353-1727
Practice Address - Street 1:4796 OLD TAR RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-9752
Practice Address - Country:US
Practice Address - Phone:252-353-4111
Practice Address - Fax:252-353-1727
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine