Individual
KUN TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
126 ENTERPRISE PATH, HIRAM, GA 30141-2656
(678) 567-0929
Mailing address
3711 LANGLEY OAKS PL SE, MARIETTA, GA 30067-4979
(864) 633-8148
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
37160
SC
2084P0800X
Psychiatry Physician
Primary
69724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37160
LICENSE
SC
01
—
69724
LICENSE
GA
Enumeration date
08/26/2010
Last updated
11/12/2020
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