Healthcare Provider Details

I. General information

NPI: 1790600104
Provider Name (Legal Business Name): HUI PANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 AIRPORT CENTER PKWY
CHARLOTTE NC
28208-5885
US

IV. Provider business mailing address

6019 KELYN HILLS DR
CHARLOTTE NC
28278-7120
US

V. Phone/Fax

Practice location:
  • Phone: 704-512-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0203X
TaxonomyClinical Molecular Genetics Physician
License Number2017165
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207SC0300X
TaxonomyClinical Cytogenetics Physician
License Number2019183
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: