Provider Demographics
NPI:1548413172
Name:ZHAN, MAOCHENG (MD)
Entity Type:Individual
Prefix:
First Name:MAOCHENG
Middle Name:
Last Name:ZHAN
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 1:524 DR. MICHAEL DEBAKEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-0000
Mailing Address - Country:US
Mailing Address - Phone:337-430-4455
Mailing Address - Fax:337-430-4454
Practice Address - Street 1:524 DR MICHAEL DEBAKEY DRIVE
Practice Address - Street 2:ST PATRICK HOSOITAL
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-0000
Practice Address - Country:US
Practice Address - Phone:337-430-4455
Practice Address - Fax:337-430-4454
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD. 203022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine