Provider Demographics
NPI:1730705609
Name:GANG, MARGERY (MD)
Entity type:Individual
Prefix:
First Name:MARGERY
Middle Name:
Last Name:GANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 FAIRVIEW AVE N # D5-100
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4433
Mailing Address - Country:US
Mailing Address - Phone:248-361-9474
Mailing Address - Fax:
Practice Address - Street 1:1100 FAIRVIEW AVE N # D5-100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4433
Practice Address - Country:US
Practice Address - Phone:248-361-9474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML61412900207RH0003X
MO2020016966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology