Provider Demographics
NPI:1588641526
Name:LAN, DAVID ZHIQIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ZHIQIANG
Last Name:LAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ZHI QIANG
Other - Middle Name:
Other - Last Name:LAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8060 WOLF RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1727
Mailing Address - Country:US
Mailing Address - Phone:901-271-1000
Mailing Address - Fax:901-271-4187
Practice Address - Street 1:8060 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1727
Practice Address - Country:US
Practice Address - Phone:901-271-1000
Practice Address - Fax:901-271-4187
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38693207R00000X, 207RC0000X, 207RC0001X
AR38693207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3896760Medicaid
TN000000032088OtherTLC
MSP00372267OtherRAIL ROAD MEDICARE
06120013301OtherQUALCHOICE
TN4146201OtherBCBS
MS02551551Medicaid
TN7826601OtherAETNA
TNP00389964OtherRAIL ROAD MEDICARE
AR99639OtherBCBS
MS02551551Medicaid
TN103I067832Medicare PIN
TN3896760Medicaid