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General NPI Number Information
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NPI Number | 1669276036
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Entity Type | Individual
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Provider Name | SAM HAN JIANG MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 100 WOODRUFF CIR NE
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City | ATLANTA
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State | GA
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Zip | 30322-4805
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Country | US
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Telephone | 339-225-5952
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 SPRING ST NW UNIT 916
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City | ATLANTA
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State | GA
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Zip | 30309-4922
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Country | US
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Telephone | 339-225-5952
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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