Song Qing Zhao, MD
Pathology, Anatomic Pathology & Clinical Pathology in Merrillville, IN. Individual provider (NPI-1).
NPI number1912944752
StatusActive
Last updated in NPPESJan 23, 2024
Details
- NPI
- 1912944752
- Entity type
- Individual (NPI-1)
- Name
- Song Qing Zhao
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2006
- Certification date
- Jan 23, 2024
- Last updated
- Jan 23, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 01077724A | IN | Yes |
| 207ZD0900X | Pathology, Dermatopathology | 45394 | WI |
Practice location
8701 BroadwayMerrillville, IN 46410-7035
Phone 219-738-5500 · Fax 219-738-6628
Mailing address
5700 Southwyck BlvdToledo, OH 43614-1509
Phone 800-288-8325 · Fax 419-866-5453
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