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NPI Code Detail

MEDICARE: ELIZABETH CHIANG DO

MEDICARE:   ELIZABETH  CHIANG  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
1207R00000XInternal Medicine Physician67371MN

General Provider Information

NPI Number : 1598297921
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH CHIANG DO
Provider Business Mailing Address
First Line : 3654 CUMMINGS AVE
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54701-7311
Country : US
Telephone Number : 715-379-0404
Fax Number :
Provider Business Practice Location Address
First Line : 2800 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1906
Country : US
Telephone Number : 612-775-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2017
Last Update Date : 05/28/2020

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