Individual
MS. GWENDOLINE FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
715 RICHLAND MALL, ONTARIO, OH 44906-3802
(567) 307-7663
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
(567) 307-7663
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35.137510
OH
207V00000X
Obstetrics & Gynecology Physician
C163159
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0390792
—
OH
05
—
100478799
—
CA
Enumeration date
04/29/2010
Last updated
05/29/2025
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