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General NPI Number Information
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NPI Number | 1891756052
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Entity Type | Individual
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Provider Name | FANG-YUN GAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 21 CROSSROADS DR STE 100
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5441
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Country | US
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Telephone | 410-356-8186
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Fax | 410-356-4180
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Provider Business Mailing Address
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Address Line | 10373A REISTERSTOWN RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3617
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Country | US
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Telephone | 410-356-8186
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Fax | 410-356-4180
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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 | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | D0061235
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0061235
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License Number State | MD
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