Provider Demographics
NPI:1225029275
Name:TANG, SHAOHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAOHUA
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-3429
Mailing Address - Country:US
Mailing Address - Phone:413-662-3530
Mailing Address - Fax:413-662-3534
Practice Address - Street 1:85 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3437
Practice Address - Country:US
Practice Address - Phone:413-662-3530
Practice Address - Fax:413-662-3534
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211264207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0197831Medicaid
MAA33199Medicare ID - Type Unspecified
MA0197831Medicaid