Provider Demographics
NPI:1497848923
Name:ZHANG, DA (MD)
Entity type:Individual
Prefix:DR
First Name:DA
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-7816
Mailing Address - Country:US
Mailing Address - Phone:913-588-7070
Mailing Address - Fax:913-588-7073
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-7070
Practice Address - Fax:913-588-7073
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31474207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36118016OtherBCBS KANSAS CITY
MO36118016OtherBCBS KANSAS CITY
KSI47908Medicare UPIN
KSP00282914Medicare ID - Type UnspecifiedRR MEDICARE