Provider Demographics
NPI:1821282948
Name:MIN, ZHAO (MD)
Entity Type:Individual
Prefix:
First Name:ZHAO
Middle Name:
Last Name:MIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 DAVIS GROVE CIRCLE
Mailing Address - Street 2:STE 107
Mailing Address - City:CARU
Mailing Address - State:NC
Mailing Address - Zip Code:27519
Mailing Address - Country:US
Mailing Address - Phone:919-363-3427
Mailing Address - Fax:919-363-3437
Practice Address - Street 1:204 DAVIS GROVE CIRCLE
Practice Address - Street 2:STE 107
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519
Practice Address - Country:US
Practice Address - Phone:919-363-3427
Practice Address - Fax:919-363-3437
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY245660208000000X
NC2008-00550207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910793Medicaid