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NPI Code Detail

MEDICARE: KYLE KHAI TANG PHARM D

MEDICARE: KYLE KHAI TANG PHARM 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist25521MD

General Provider Information

NPI Number : 1538625579
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE KHAI TANG PHARM D
Provider Business Mailing Address
First Line : 10303 THIRTY KNOTS LN
Second Line :
City : BERLIN
State : MD
Zip : 21811-3402
Country : US
Telephone Number : 215-868-8129
Fax Number :
Provider Business Practice Location Address
First Line : 125 E NORTH POINTE DR
Second Line :
City : SALISBURY
State : MD
Zip : 21804-2283
Country : US
Telephone Number : 410-572-8518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2019
Last Update Date : 02/14/2019

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Directions to “ KYLE KHAI TANG PHARM D” Practice Location

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