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Individual

DR. STEPHEN T ANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1054 M L KING DR, SUITE 120, CENTRALIA, IL 62801-3000
(618) 532-1688
(618) 532-1689
Mailing address
1054 M L KING DR, SUITE 120, CENTRALIA, IL 62801-3000
(618) 532-1688
(618) 532-1689

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06107347
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/10/2006
Last updated
07/08/2007
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