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Individual

RUI WEN PANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5224 W DOVE CENTRE RD, MARANA, AZ 85658-5063
(520) 616-1445
(520) 616-1446
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 616-1445
(520) 616-1446

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58715
AZ
207R00000X
Internal Medicine Physician
R75316
AZ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
236665
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
528748
AZ
Enumeration date
06/26/2015
Last updated
07/22/2021
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