Provider Demographics
NPI:1750412755
Name:ZHANG, RENCHI (L AC)
Entity type:Individual
Prefix:DR
First Name:RENCHI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHEFFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2707
Mailing Address - Country:US
Mailing Address - Phone:207-772-5368
Mailing Address - Fax:
Practice Address - Street 1:4 SHEFFIELD ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2707
Practice Address - Country:US
Practice Address - Phone:207-772-5368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC 139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME026399OtherANTHEM BLUE CROSS
ME1244020OtherCIGNA NETWORK MEMBER ID