Individual
QUAN FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425-8905
(843) 792-4638
(843) 792-3315
Mailing address
169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425-8905
(843) 792-4638
(843) 792-3315
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL34517
SC
Other
Enumeration date
04/28/2012
Last updated
04/28/2012
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