Individual
MAI KHOU VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
915 TATE BLVD SE, SUITE 186, HICKORY, NC 28602-4042
(828) 449-8458
(828) 323-8348
Mailing address
915 TATE BLVD SE, SUITE 186, HICKORY, NC 28602-4042
(828) 449-8458
(828) 323-8348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104079
NC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104079
LICENSE
NC
Enumeration date
07/08/2006
Last updated
03/07/2023
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