Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 043317 | CT |
N | 207V00000X | Obstetrician & Gynecologist | 2020-00929 | NC |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 043317 | CT |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2020-00929 | NC |
NPI | 1134284466 |
---|---|
Provider Name | Yu Ming Victor Fang |
First Address | Atlanta, GA 30374-5040 |
Second Address | Greensboro, NC 27405-6967 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 18/08/2021 |