Provider Demographics
NPI:1699851063
Name:ZHANG, GRANT (PHD)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:GUOQIANG
Other - Middle Name:G
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:9805 GWYNN PARK DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5707
Mailing Address - Country:US
Mailing Address - Phone:410-274-0614
Mailing Address - Fax:
Practice Address - Street 1:4801 DORSEY HALL DR STE 212
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7749
Practice Address - Country:US
Practice Address - Phone:410-274-0614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00572171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK914OtherCAREFIRST BCBS PROVIDER
MDBK23GOtherCAREFIRST BCBS MD PROVIDE