# DARTMOUTH MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dartmouth Medical, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679347033
- **Authorized official:** JIAN LIANG PANG MD (CEO)
- **Authorized official phone:** (617) 610-9339

## Contact information

- **Practice address:** 2959 SHARPSBURG MCCULLUM RD \# 103, NEWNAN, GA 30265-2297
- **Practice address phone:** (617) 610-9339
- **Mailing address:** 2959 SHARPSBURG MCCULLUM RD \# 103, NEWNAN, GA 30265-2297
- **Mailing address phone:** (770) 202-1642
- **Mailing address fax:** (770) 202-1643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/07/2023
- **Last updated:** 01/25/2024