Jiang, Fangda

Jiang, Fangda is an individual health care provider with primary practice located at 210 Wisconsin American Dr , Fond Du Lac WI 54937-2999. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Jiang, Fangda can be contacted via phone (920) 907-7500.

Contact Information

Primary practice address
210 Wisconsin American Dr Fond Du Lac WI 54937-2999
Phone: (920) 907-7500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PT20162 North Dakota
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X MT221145 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 84732 Wisconsin
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 84732 Wisconsin

Profile Details

NPI number 1255955159
LBN Legal business name Jiang, Fangda
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2020
Last updated Jan 28th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255955159 NPPES
Wisconsin MEDICAID 100297012

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