Provider Demographics
NPI:1366556185
Name:ZHENG, YONG TAO (MD)
Entity type:Individual
Prefix:
First Name:YONG
Middle Name:TAO
Last Name:ZHENG
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 1:2000 MEDICAL PKWY STE 409
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3746
Mailing Address - Country:US
Mailing Address - Phone:667-204-7212
Mailing Address - Fax:443-481-4151
Practice Address - Street 1:4175 N HANSON CT STE 201
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3181
Practice Address - Country:US
Practice Address - Phone:443-481-1199
Practice Address - Fax:443-481-1495
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0426455207V00000X
MDD73148207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD048504700Medicaid
01472133OtherAMERIGROUP
256538OtherJHHC
N4350008OtherBCBS
7553448OtherAETNA PPO
MD048504700Medicaid
01472133OtherAMERIGROUP