Basic Information
| Provider Information | |||||||||
| NPI: | 1689884587 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TANG | ||||||||
| FirstName: | BINGFENG | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 395 W 12TH AVE | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142938299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 395 W 12TH AVE | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142938299 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 04/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0904X | 35095572 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085N0904X | 4301087766 | MI | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology |
ID Information
| ID | Type | State | Issuer | Description | 314421 | 05 | OH | MEDICAID |