# CHARLIE WEICHIN FANG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1609962521
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 0101251958 | VA | — |
| 207P00000X | Emergency Medicine Physician | 055513 | GA | — |
| 207P00000X | Emergency Medicine Physician | 38728 | TN | — |
| 207Q00000X | Family Medicine Physician | 38728 | TN | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 12/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 331010801A | — | GA |
| 05 | — | 3898281 | — | TN |
| 01 | — | 4087933 | BCBSTN | TN |
| 05 | — | 64088644 | — | KY |
| 01 | — | P00231542 | RAILROAD | TN |
| 01 | — | P00288351 | RAILROAD | GA |