Provider Demographics
NPI:1831181239
Name:VANG, TOUBER (MD)
Entity type:Individual
Prefix:
First Name:TOUBER
Middle Name:
Last Name:VANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TOUBER
Other - Middle Name:
Other - Last Name:VANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-0726
Mailing Address - Country:US
Mailing Address - Phone:910-572-1785
Mailing Address - Fax:910-572-2723
Practice Address - Street 1:1038 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-8685
Practice Address - Country:US
Practice Address - Phone:910-572-1785
Practice Address - Fax:910-572-2723
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201193207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00246988OtherRAILROAD MEDICARE
NC5900721Medicaid
NCH75425Medicare UPIN
NC5900721Medicaid