Healthcare Provider Details

I. General information

NPI: 1871836833
Provider Name (Legal Business Name): LING YAN M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6111 EXECUTIVE BLVD
ROCKVILLE MD
20852-3911
US

IV. Provider business mailing address

6111 EXECUTIVE BLVD
ROCKVILLE MD
20852-3911
US

V. Phone/Fax

Practice location:
  • Phone: 301-255-4041
  • Fax:
Mailing address:
  • Phone: 301-255-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD046084
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD85210
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: