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General NPI Number Information
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NPI Number | 1548794225
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Entity Type | Individual
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Provider Name | HONG JIANG MD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 417 STATE ST STE 349
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City | BANGOR
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State | ME
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Zip | 04401-6630
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Country | US
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Telephone | 207-941-8200
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Fax | 207-947-4061
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Provider Business Mailing Address
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Address Line | 417 STATE ST STE 349
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City | BANGOR
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State | ME
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Zip | 04401-6630
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Country | US
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Telephone | 207-941-8200
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Fax | 207-947-4061
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD24489
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 65003
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License Number State | MN
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