Individual
TIAN LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 MOYE BLVD, GREENVILLE, NC 27834-4300
(252) 744-2803
(252) 744-3616
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2019-01430
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447661392
—
NC
01
—
NN7799A
MEDICARE
NC
Enumeration date
05/14/2014
Last updated
09/30/2021
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