Provider Demographics
NPI:1326379249
Name:TIAN, LIGENG (BM)
Entity Type:Individual
Prefix:DR
First Name:LIGENG
Middle Name:
Last Name:TIAN
Suffix:
Gender:F
Credentials:BM
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Mailing Address - Street 1:6350 CENTER DR
Mailing Address - Street 2:STE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4107
Mailing Address - Country:US
Mailing Address - Phone:757-213-5700
Mailing Address - Fax:757-213-5701
Practice Address - Street 1:1051 LOFTIS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3069
Practice Address - Country:US
Practice Address - Phone:757-873-9400
Practice Address - Fax:757-873-9420
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2018-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101253898207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326379249OtherAETNA
VA1326379249Medicaid
VA1326379249OtherTRICARE
VA1326379249OtherOPTIMA