Provider Demographics
NPI:1164740890
Name:FANG, XIAOHONG (MD)
Entity Type:Individual
Prefix:DR
First Name:XIAOHONG
Middle Name:
Last Name:FANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 818
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-0818
Mailing Address - Country:US
Mailing Address - Phone:585-798-3992
Mailing Address - Fax:585-798-3865
Practice Address - Street 1:3435 MAIN ST
Practice Address - Street 2:HAYES ANNEX A, DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-3001
Practice Address - Country:US
Practice Address - Phone:716-829-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273108207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology