Provider Demographics
NPI:1982645966
Name:TANG, WANZHU (MD)
Entity Type:Individual
Prefix:DR
First Name:WANZHU
Middle Name:
Last Name:TANG
Suffix:
Gender:F
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:P.O. BOX 26
Mailing Address - Street 2:
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-0026
Mailing Address - Country:US
Mailing Address - Phone:215-283-2838
Mailing Address - Fax:215-283-9978
Practice Address - Street 1:858 E. WELSH RD
Practice Address - Street 2:SUITE 10
Practice Address - City:MAPLE GLEN
Practice Address - State:PA
Practice Address - Zip Code:19002
Practice Address - Country:US
Practice Address - Phone:215-283-2838
Practice Address - Fax:215-283-9978
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-070052-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD-070052-LOtherLICENSE NUMBER OF PA
PAH32770Medicare UPIN
046111QK2Medicare ID - Type Unspecified