Individual
SHAN JIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5925
(800) 945-9877
(801) 733-5618
Mailing address
3030 DAVIS RD APT C7, FAIRBANKS, AK 99709-5270
(907) 460-0222
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5387
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD2985
—
AK
Enumeration date
07/25/2006
Last updated
07/08/2007
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