Individual
GONGQIAO ZHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 OAK LEE DR, RANSON, WV 25438-4879
(304) 930-0001
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(154) 053-6510
(304) 428-2597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002256
VA
363A00000X
Physician Assistant
Primary
01492
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01492
WEST VIRGINIA PA LICENSE
WV
Enumeration date
01/17/2007
Last updated
03/07/2023
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