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NPI Code Detail

MEDICARE: JUNGER TANG M.D.

MEDICARE: JUNGER TANG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician47799MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508830605
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUNGER TANG M.D.
Provider Business Mailing Address
First Line : 4225 GOLDEN VALLEY RD
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-4215
Country : US
Telephone Number : 763-588-0661
Fax Number :
Provider Business Practice Location Address
First Line : 4225 GOLDEN VALLEY RD
Second Line :
City : GOLDEN VALLEY
State : MN
Zip : 55422-4215
Country : US
Telephone Number : 763-588-0661
Fax Number : 763-302-4345
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/26/2011

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