Provider Demographics
NPI:1104118843
Name:CHIANG, AUSTIN LEE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:LEE
Last Name:CHIANG
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:132 S 10TH STREET
Mailing Address - Street 2:480 MAIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-955-3947
Mailing Address - Fax:215-955-5245
Practice Address - Street 1:1101 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3612
Practice Address - Country:US
Practice Address - Phone:215-955-8900
Practice Address - Fax:215-955-5245
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD461083207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology