Provider Demographics
NPI:1851332928
Name:ZENG, GUANGBIN (MD)
Entity Type:Individual
Prefix:
First Name:GUANGBIN
Middle Name:
Last Name:ZENG
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:PO BOX 601843
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 E INDEPENDENCE BLVD STE B
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4628
Practice Address - Country:US
Practice Address - Phone:704-815-5624
Practice Address - Fax:704-815-5621
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129GKMedicaid
SCNC677Medicaid
NC2296874Medicare ID - Type Unspecified
NC89129GKMedicaid
NCNC2333AMedicare PIN