Basic Information
Provider Information
NPI: 1033347455
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YANG
FirstName: ZHAO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D., PH.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3100 SPRING FOREST RD
Address2: SUITE 130
City: RALEIGH
State: NC
PostalCode: 276162880
CountryCode: US
TelephoneNumber: 9198820705
FaxNumber: 9198739821
Practice Location
Address1: 3300 GALLOWS RD
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423307
CountryCode: US
TelephoneNumber: 7037763138
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2009
LastUpdateDate: 07/29/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X0101255608VAY Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XD0075395MDN Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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