Provider Demographics
NPI:1578596938
Name:TUNG, WILLIAM SIAO-PING (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SIAO-PING
Last Name:TUNG
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 1:1802 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7357
Mailing Address - Country:US
Mailing Address - Phone:540-776-2010
Mailing Address - Fax:540-725-5016
Practice Address - Street 1:1802 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7357
Practice Address - Country:US
Practice Address - Phone:540-776-2010
Practice Address - Fax:540-725-5016
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090204582086S0129X
PAMD4305182086S0129X
VA01012539752086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR179422001Medicaid
MO1578596938Medicaid
VA1578596938Medicaid
MO639934OtherBCBS
PA1019962960001Medicaid
IL1578596938Medicaid
PAP00410365OtherMEDICARE RAILROAD
MO992182OtherHEALTHLINK
VA1578596938Medicaid
VAVV9799AMedicare PIN
PAD00410365Medicare PIN
MO992182OtherHEALTHLINK
IL1578596938Medicaid
PA1019962960001Medicaid