Provider Demographics
NPI:1356381537
Name:ZHONG, WEN (MD)
Entity type:Individual
Prefix:DR
First Name:WEN
Middle Name:
Last Name:ZHONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6047 W KRISTAL WAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7802
Mailing Address - Country:US
Mailing Address - Phone:623-876-3800
Mailing Address - Fax:623-972-9590
Practice Address - Street 1:5000 KY ROUTE 321
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9113
Practice Address - Country:US
Practice Address - Phone:606-886-7645
Practice Address - Fax:606-889-6206
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27367208M00000X
AZ26766207R00000X
IDM-14778208M00000X, 207R00000X
WAMD60405795207R00000X
KYC3164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ440686-02Medicaid
AZ300087366OtherRAILROAD MEDICARE PIN
AZ440686Medicaid
AZ300087366OtherRAILROAD MEDICARE PIN
AZG70300Medicare UPIN
AZ440686Medicaid
AZZ23225Medicare PIN