Provider Demographics
NPI:1043485634
Name:ZHAO, DANHONG (MD)
Entity type:Individual
Prefix:
First Name:DANHONG
Middle Name:
Last Name:ZHAO
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 1:42 DARLING PARKE DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3276
Mailing Address - Country:US
Mailing Address - Phone:773-936-3967
Mailing Address - Fax:925-944-9709
Practice Address - Street 1:42 DARLING PARKE DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3276
Practice Address - Country:US
Practice Address - Phone:773-936-3967
Practice Address - Fax:925-944-9709
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD84822084P0800X
390200000X
MEMD214222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program