Healthcare Provider Details

I. General information

NPI: 1316749021
Provider Name (Legal Business Name): WENJIAN TIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 09/30/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH) UNIT # 15245 ; BLDG 6370
APO AP
96271
US

IV. Provider business mailing address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH) UNIT # 15245 ; BLDG 6370
APO AP
96271
US

V. Phone/Fax

Practice location:
  • Phone: 503-337-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101290319
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: