Provider Demographics
NPI:1952480238
Name:ZHANG, JIN X (MD)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:X
Last Name:ZHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11803 JEFFERSON AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-534-7701
Mailing Address - Fax:757-534-7708
Practice Address - Street 1:11803 JEFFERSON AVENUE
Practice Address - Street 2:SUITE 230
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-534-7701
Practice Address - Fax:757-534-7708
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0615207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173396602Medicaid
TX173396604Medicaid
TX173396603Medicaid
TX173396601Medicaid
TX173396602Medicaid
TX8D5363Medicare PIN
TX8D5361Medicare PIN
TX8D5362Medicare PIN