Provider Demographics
NPI:1629062450
Name:TANG, WOZHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WOZHAN
Middle Name:
Last Name:TANG
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:PO BOX 35781
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-0781
Mailing Address - Country:US
Mailing Address - Phone:276-670-2400
Mailing Address - Fax:276-670-2406
Practice Address - Street 1:5801 BREMO RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1907
Practice Address - Country:US
Practice Address - Phone:804-281-8100
Practice Address - Fax:804-285-7419
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238095207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010186587Medicaid
VA297331OtherANTHEM
VA010186561Medicaid
VA1629062450Medicaid
VA010196116Medicaid
VA297331OtherANTHEM
VA010186587Medicaid
VA1629062450Medicaid
VA010196116Medicaid