Provider Demographics
NPI:1134541949
Name:LI, ZHAOBO (MD, PHD, LAC)
Entity type:Individual
Prefix:
First Name:ZHAOBO
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD, PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 YORK RD STE 305A
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6054
Mailing Address - Country:US
Mailing Address - Phone:443-310-5382
Mailing Address - Fax:
Practice Address - Street 1:1407 YORK RD STE 305
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6054
Practice Address - Country:US
Practice Address - Phone:443-310-5382
Practice Address - Fax:667-206-2956
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02086171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist