Provider Demographics
NPI:1154768604
Name:ZHANG, MIMI WEI (MD)
Entity type:Individual
Prefix:
First Name:MIMI
Middle Name:WEI
Last Name:ZHANG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:WEI
Other - Middle Name:
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 FRASIER ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2125
Mailing Address - Country:US
Mailing Address - Phone:919-477-7003
Mailing Address - Fax:919-471-2827
Practice Address - Street 1:11725 ILLINOIS ST STE 558
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3009
Practice Address - Country:US
Practice Address - Phone:317-688-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01079842A208800000X
NC2019-00104208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty