Provider Demographics
NPI:1669031423
Name:JIANG, KAI
Entity Type:Individual
Prefix:
First Name:KAI
Middle Name:
Last Name:JIANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 4TH ST SW APT 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-3286
Mailing Address - Country:US
Mailing Address - Phone:216-785-0171
Mailing Address - Fax:
Practice Address - Street 1:617 4TH ST SW APT 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-3286
Practice Address - Country:US
Practice Address - Phone:216-785-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD000002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology