Provider Demographics
NPI:1427010040
Name:ZHANG, DAHUA (MD)
Entity Type:Individual
Prefix:
First Name:DAHUA
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CENTRAL AVE SE
Mailing Address - Street 2:PHS - LAB - S1
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4930
Mailing Address - Country:US
Mailing Address - Phone:505-841-1330
Mailing Address - Fax:505-841-1373
Practice Address - Street 1:1100 CENTRAL AVE SE
Practice Address - Street 2:PHS - LAB - S1
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4930
Practice Address - Country:US
Practice Address - Phone:505-841-1330
Practice Address - Fax:505-841-1373
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47169207ZP0105X
NMMD2007-0187207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM301155Medicare PIN
NMNM301154Medicare PIN