Provider Demographics
NPI:1407254717
Name:FENG, JIAN (MD)
Entity Type:Individual
Prefix:
First Name:JIAN
Middle Name:
Last Name:FENG
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 1:2116 MONTREAT LN APT B
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4021
Mailing Address - Country:US
Mailing Address - Phone:205-567-5314
Mailing Address - Fax:
Practice Address - Street 1:2116 MONTREAT LN APT B
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-4021
Practice Address - Country:US
Practice Address - Phone:205-567-5314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine