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Individual

MAYNARD K PANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
250 PLEASANT ST, SUITE 6073, CONCORD, NH 03301-7539
(603) 227-7000
(603) 227-7191
Mailing address
250 PLEASANT ST, SUITE 6073, CONCORD, NH 03301-7539
(603) 227-7000
(603) 227-7191

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12219
NH
208M00000X
Hospitalist Physician
Primary
12219
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1473C
BLUECROSS BLUESHIELD
NC
05
30204363
NH
05
5908841
NC
01
812443
BLUE MEDICARE
NC
01
P00479038
RAILROAD MEDICARE
NC
Enumeration date
08/01/2006
Last updated
04/19/2017
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