Individual
JAMES C FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 213-4060
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35-088454
OH
207RC0000X
Cardiovascular Disease Physician
77319
MA
207RC0000X
Cardiovascular Disease Physician
Primary
8555716-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224446
UNISON
OH
01
—
000000539492
ANTHEM
OH
05
—
267792
—
OH
01
—
363520
WELLCARE
OH
01
—
5198667
AETNA
OH
01
—
743259
BUCKEYE
OH
01
—
P00449274
RAILROAD MEDICARE
OH
Enumeration date
04/28/2006
Last updated
10/26/2021
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