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Deactivated NPI 1245895606 Deactivated / Inactive NPI Male Practitioner

Dr. Dong Fang Zhao , MD

General Practice • Grosse Pointe Park, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Dong Fang Zhao has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 01, 2019
NPI Deactivation Date December 16, 2019
Total Practice Duration ~1 Years of Practice (2019 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Dong Fang Zhao, MD was a registered General Practice practicing in Grosse Pointe Park, MI. Throughout an active medical career spanning 1 years, Dr. Zhao provided care at the practice location at 15001 KERCHEVAL AVE PMB 502 until profile deactivation on 2019-12-16.

Practice Location & Contact Primary Location

Practice Address

15001 Kercheval Ave Pmb 502

Grosse Pointe Park, MI 482301361

Telephone 8103227952

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Grosse Pointe Park, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 29.4 Yrs
Regional Practice Density
1 Specialists

Practicing in Grosse Pointe Park, MI (445 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-07-12
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MI 4301505594

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
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Updated Practice Location July 12, 2022

Registered at 15001 KERCHEVAL AVE PMB 502, GROSSE POINTE PARK, MI 482301361 (Tel: 8103227952)

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Updated Business Mailing Address July 12, 2022

Registered at 15001 KERCHEVAL AVE PMB 502, GROSSE POINTE PARK, MI 482301361 (Tel: 8103227952)

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Updated Practice Location May 29, 2022

Registered at 2168 GULLIVER DR, TROY, MI 480851034 (Tel: 8103227952)

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Updated Business Mailing Address May 29, 2022

Registered at 2168 GULLIVER DR, TROY, MI 480851034 (Tel: 8103227952)

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2022

General Practice (License #4301505594 in MI)

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Updated Practice Location February 13, 2020

Registered at 6071 WEST OUTER DRIVE SINAI-GRACE HOSPITAL/DMC,, DEPARTMENT OF MEDICINE, 4TH FLOOR, M-408, DETROIT, MI 48235 (Tel: 3139661728)

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Updated Business Mailing Address February 13, 2020

Registered at 6071 WEST OUTER DRIVE SINAI-GRACE HOSPITAL/DMC,, DEPARTMENT OF MEDICINE, 4TH FLOOR, M-408, DETROIT, MI 48235 (Tel: 3139661728)

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Provider Name / Credentials Updated February 13, 2020

Recorded as DONG FANG ZHAO, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2020

Student in an Organized Health Care Education/Training Program

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NPI Profile Deactivated December 16, 2019

Record deactivated on December 16, 2019

NPI Profile Active May 01, 2019

NPI status registered as active in NPPES database

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Updated Practice Location May 01, 2019

Registered at 6071 WEST OUTER DRIVE, SINAI-GRACE HOSPITAL/DMC, 4TH FLOOR M-408, DEPARTMENT OF MEDICINE, DETROIT, MI 48235 (Tel: 3139661728)

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Updated Business Mailing Address May 01, 2019

Registered at 1880 EAST KENT AVENUE SOUTH, SUITE 306, VANCOUVER, BC V5P 2S7

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Provider Name / Credentials Updated May 01, 2019

Recorded as DONG FANG ZHAO, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2019

Student in an Organized Health Care Education/Training Program

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Initial NPI Registration & Enumeration May 01, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245895606
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 01, 2019
Last Update: July 12, 2022
Deactivation Date: December 16, 2019
Sole Proprietor: No

Mailing Address

15001 Kercheval Ave Pmb 502

Grosse Pointe Park, MI 482301361

Phone: 8103227952

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.