Healthcare Provider Details

I. General information

NPI: 1306604822
Provider Name (Legal Business Name): ZHENGDONG TANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CANDUN DR STE 104
APEX NC
27523-6413
US

IV. Provider business mailing address

2201 CANDUN DR STE 104
APEX NC
27523-6413
US

V. Phone/Fax

Practice location:
  • Phone: 919-725-1778
  • Fax: 919-516-9725
Mailing address:
  • Phone: 919-725-1778
  • Fax: 919-516-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: