Provider Demographics
NPI:1043243827
Name:CHIANG, ALFRED P (DO)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:P
Last Name:CHIANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 CAMPUS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2601
Mailing Address - Country:US
Mailing Address - Phone:763-519-0634
Mailing Address - Fax:763-519-0636
Practice Address - Street 1:2700 CAMPUS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2601
Practice Address - Country:US
Practice Address - Phone:763-519-0634
Practice Address - Fax:763-519-0636
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1790207R00000X
MN53688207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine