Basic Information
| Provider Information | |||||||||
| NPI: | 1720034986 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHIANG | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | YAT-FUNG | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | 700 KMS PLACE | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349362047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DR | ||||||||
| Address2: | B1 FLOOR CANCER RECP B | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349366000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 03/25/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | MD422545 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 4301095754 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207R00000X | 4301095754 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 4301095754 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RX0202X | 4301095754 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.