Provider Demographics
NPI:1689766461
Name:ZHU, WEIMIN R (MD)
Entity Type:Individual
Prefix:
First Name:WEIMIN
Middle Name:R
Last Name:ZHU
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 1:3455 WILKENS AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5265
Mailing Address - Country:US
Mailing Address - Phone:410-644-4320
Mailing Address - Fax:
Practice Address - Street 1:3455 WILKENS AVE STE 208
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5265
Practice Address - Country:US
Practice Address - Phone:410-644-4320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056143207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCW2270018OtherGHI
MD61489901OtherBLUE SHIELD
MD607L04KKMedicare ID - Type Unspecified
MD61489901OtherBLUE SHIELD