Individual
GRACE K JANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 TOZER RD STE 202, BEVERLY, MA 01915-5514
(978) 927-7727
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1016183
MA
207Q00000X
Family Medicine Physician
30810
MN
207Q00000X
Family Medicine Physician
69675
MN
Other
Enumeration date
05/18/2020
Last updated
01/16/2024
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