Provider Demographics
NPI:1316982630
Name:ZHU, GAOYONG (MD)
Entity type:Individual
Prefix:
First Name:GAOYONG
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:412 DURANT STREET
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0246
Mailing Address - Country:US
Mailing Address - Phone:434-447-2898
Mailing Address - Fax:434-447-3456
Practice Address - Street 1:412 DURANT ST
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1614
Practice Address - Country:US
Practice Address - Phone:434-447-2898
Practice Address - Fax:434-447-3456
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207302207RX0202X
VA0101240696173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI23528Medicare UPIN
NY9255REMedicare ID - Type Unspecified