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Individual

DR. SHOURONG ZHAO

Active
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Individual

DR. SHOURONG ZHAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
058248
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058248
STATE LICENSE
GA
05
—
146707510A
—
GA
01
—
60045007
BCBS
AL
01
—
60105169
BCBS
AL
01
—
60105170
BCBS
AL
Enumeration date
08/01/2006
Last updated
07/27/2015
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