Healthcare Provider Details

I. General information

NPI: 1851765200
Provider Name (Legal Business Name): HANSEN MING TANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 S PARK ST
KALAMAZOO MI
49007-5118
US

IV. Provider business mailing address

524 S PARK ST
KALAMAZOO MI
49007-5118
US

V. Phone/Fax

Practice location:
  • Phone: 269-341-6056
  • Fax: 269-341-7781
Mailing address:
  • Phone: 269-341-6056
  • Fax: 269-341-7781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101028684
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: