MEDICARE: ANDREW VANG DO

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	207P00000X	Emergency Medicine Physician	34.013204	OH

General Provider Information

NPI Number	:	1265895262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW VANG DO

Provider Business Mailing Address
First Line	:	967 LARKFIELD DR
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-5733
Country	:	US
Telephone Number	:	614-886-0121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4503 GLENHAVEN DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-5987
Country	:	US
Telephone Number	:	614-886-0121
Fax Number	:

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

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	07/06/2020

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Directions to “ ANDREW VANG DO” Practice Location

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