Provider Demographics
NPI:1891904926
Name:RONG ZHANG M.D., PH.D. LLC
Entity Type:Organization
Organization Name:RONG ZHANG M.D., PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-261-8558
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:WEST FRIENDSHIP
Mailing Address - State:MD
Mailing Address - Zip Code:21794-0097
Mailing Address - Country:US
Mailing Address - Phone:410-261-8558
Mailing Address - Fax:410-261-8744
Practice Address - Street 1:3333 N CALVERT ST
Practice Address - Street 2:SUITE 575
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2867
Practice Address - Country:US
Practice Address - Phone:410-261-8558
Practice Address - Fax:410-261-8744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD055059261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406053900Medicaid
MD685MMedicare PIN
H00444Medicare UPIN