Individual
PANG SOUA HANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6901 W EDGERTON AVE, GREENFIELD, WI 53220-4420
(414) 421-8400
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77088
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100211406
—
WI
Enumeration date
04/08/2020
Last updated
08/16/2023
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