Individual
BEVERLY J. FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, MSTF 800, BALTIMORE, MD 21201-1544
(410) 706-4771
(410) 706-0345
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 225-8000
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
D69060
MD
207RS0012X
Sleep Medicine (Internal Medicine) Physician
D65060
MD
2084P0800X
Psychiatry Physician
A 113011
CA
2084P0800X
Psychiatry Physician
Primary
D 65060
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440038100
—
MD
01
—
S062-0566
CAREFIRST BC/BS
MD
Enumeration date
03/06/2007
Last updated
03/10/2026
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