Doctor Name: | GANG LI |
NPI Number: | 1144217795 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | D0053730 |
Business Practice Address: | 5401 Old Court Rd Randallstown, MD - 211335103 |
Business Phone Number: | 4105212200 |
Business Fax Number: | |
Mailing Address: | 11781 Lee Jackson Memorial Hwy, Suite 550 FAIRFAX |
State: | VA |
Postal Code: | 220333309 |
Phone Number: | 5717775157 |
Fax Number: | 7038902650 |
NPI Enumeration Date: | 09/29/2005 |
NPI Last Update Date: | 10/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | D0053730 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |