MEDICARE: AYLMER C TANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD074199L	PA
2	207RC0000X	Cardiovascular Disease Physician	MD074199L	PA
3	207RI0011X	Interventional Cardiology Physician	MD074199L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	285049	OTHER	PA	UNISON
3	MD074199L	OTHER	PA	LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	50089141	OTHER	PA	CAPITAL BLUECROSS

General Provider Information

NPI Number	:	1073514550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYLMER C TANG MD

Provider Business Mailing Address
First Line	:	785 5TH AVE STE 3
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-4232
Country	:	US
Telephone Number	:	717-263-9555
Fax Number	:	717-709-6529

Provider Business Practice Location Address
First Line	:	12 ST PAUL DR STE 204
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-1035
Country	:	US
Telephone Number	:	717-217-6886
Fax Number	:	717-217-6896

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/08/2021

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Directions to “ AYLMER C TANG MD” Practice Location

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