Provider Demographics
NPI:1922784909
Name:FENG, MINGLI (DO)
Entity Type:Individual
Prefix:
First Name:MINGLI
Middle Name:
Last Name:FENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:FENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:4240 AERIE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809
Mailing Address - Country:US
Mailing Address - Phone:404-735-2851
Mailing Address - Fax:
Practice Address - Street 1:4240 AERIE CIRCLE
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809
Practice Address - Country:US
Practice Address - Phone:404-735-2851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine