Basic Information
| Provider Information | |||||||||
| NPI: | 1851773600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DANG | ||||||||
| FirstName: | MICHAEL KIN MAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25500 POINT LOOKOUT RD | ||||||||
| Address2: | |||||||||
| City: | LEONARDTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206502015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014758981 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25500 POINT LOOKOUT RD | ||||||||
| Address2: | |||||||||
| City: | LEONARDTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206502015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014758981 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2015 | ||||||||
| LastUpdateDate: | 06/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0090669 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | D0090669 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0200X | D0090669 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.