Provider Demographics
NPI:1629537485
Name:JIANG, TIANLUN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:TIANLUN
Middle Name:
Last Name:JIANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:JIANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:5750 CENTRE AVE STE 500
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3789
Practice Address - Country:US
Practice Address - Phone:412-683-5211
Practice Address - Fax:412-683-0737
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD481204207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology