Provider Demographics
NPI:1659665917
Name:TANG, CANDY SIU-WAI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CANDY
Middle Name:SIU-WAI
Last Name:TANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 GOVERNOR RITCHIE HWY
Mailing Address - Street 2:T-1938
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2318
Mailing Address - Country:US
Mailing Address - Phone:410-487-0039
Mailing Address - Fax:410-487-0039
Practice Address - Street 1:6717 GOVERNOR RITCHIE HWY
Practice Address - Street 2:T-1938
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2318
Practice Address - Country:US
Practice Address - Phone:410-487-0039
Practice Address - Fax:410-487-0039
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist