Provider Demographics
NPI:1992772818
Name:ZHAO, JOHN Y (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:Y
Last Name:ZHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YANG
Other - Middle Name:
Other - Last Name:ZHAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3963 LOOMIS PKWY
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-1800
Mailing Address - Country:US
Mailing Address - Phone:330-235-7070
Mailing Address - Fax:330-235-7071
Practice Address - Street 1:3963 LOOMIS PKWY
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1800
Practice Address - Country:US
Practice Address - Phone:330-296-6441
Practice Address - Fax:330-296-2818
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.071749Z208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH2486957Medicaid
OH4132897Medicare PIN
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #