Provider Demographics
NPI:1841248150
Name:TA, NANG THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:NANG
Middle Name:THOMAS
Last Name:TA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1520 LYON CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-5320
Mailing Address - Country:US
Mailing Address - Phone:704-567-8218
Mailing Address - Fax:704-567-1717
Practice Address - Street 1:1520 LYON CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-5320
Practice Address - Country:US
Practice Address - Phone:704-567-8218
Practice Address - Fax:704-567-1717
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine