Provider Demographics
NPI:1558637058
Name:PANG, JIAN LIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:JIAN
Middle Name:LIANG
Last Name:PANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JIAN
Other - Middle Name:
Other - Last Name:LIANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2959 SHARPSBURG MCCULLUM RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2297
Mailing Address - Country:US
Mailing Address - Phone:770-202-1642
Mailing Address - Fax:770-202-1643
Practice Address - Street 1:2959 SHARPSBURG MCCULLUM RD STE 103
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2297
Practice Address - Country:US
Practice Address - Phone:770-202-1642
Practice Address - Fax:770-202-1643
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA079207207QA0505X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine