Individual
LYDIA TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 706-6957
(410) 706-6859
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 706-6957
(410) 706-6859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME 109871
FL
207RI0200X
Infectious Disease Physician
Primary
D77744
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214280500
—
MD
01
—
S062-0562
CAREFIRST BC/BS
MD
Enumeration date
10/01/2008
Last updated
04/06/2015
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