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General NPI Number Information
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NPI Number | 1629788849
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Entity Type | Organization
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Legal Business Name | STEPHEN TAMANG MD CONSULTING SCHANGERVICES PC
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 625 FLORMANN ST
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City | RAPID CITY
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State | SD
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Zip | 57701-5469
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Country | US
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Telephone | 605-340-1234
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24154
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City | BELFAST
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State | ME
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Zip | 04915-4492
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Country | US
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Telephone | 605-467-8030
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Fax |
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Authorized Official
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Title or Position | SENIOR MANAGER, CREDENTIALING
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Name | KATRINA MERRITT
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Credential |
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Telephone | 813-596-5726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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