Individual
SHAN TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1839 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 323-1463
(910) 323-1575
Mailing address
1839 QUIET CV, FAYETTEVILLE, NC 28304-3857
(910) 323-1463
(910) 323-1575
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
201500826
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2010
Last updated
07/08/2015
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