Provider Demographics
NPI:1952741761
Name:ZHANG, DAINA (MD)
Entity type:Individual
Prefix:
First Name:DAINA
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:XIAOHUO
Other - Middle Name:
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-849-6000
Mailing Address - Fax:314-849-1417
Practice Address - Street 1:12345 W BEND DR STE 300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2255
Practice Address - Country:US
Practice Address - Phone:314-849-6000
Practice Address - Fax:314-849-1417
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016022281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO124510122Medicare PIN