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General NPI Number Information
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NPI Number | 1518369560
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Entity Type | Individual
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Provider Name | JOANA KANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 84 MARGINAL WAY STE 800
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City | PORTLAND
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State | ME
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Zip | 04101-2475
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Country | US
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Telephone | 207-774-5816
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GANNETT DR STE C
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-5900
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Country | US
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Telephone | 207-782-8036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 59450
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 59450
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License Number State | MN
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