Provider Demographics
NPI:1699764944
Name:DANG, SON N (MD)
Entity type:Individual
Prefix:DR
First Name:SON
Middle Name:N
Last Name:DANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2606 WALES AVE NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2340
Mailing Address - Country:US
Mailing Address - Phone:330-834-4735
Mailing Address - Fax:330-834-4736
Practice Address - Street 1:2606 WALES AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2340
Practice Address - Country:US
Practice Address - Phone:330-834-4735
Practice Address - Fax:330-834-4736
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2016-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35071045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH043700096OtherPHCS
OH331940002OtherCARESOURCE
OH2034828Medicaid
OH2836702OtherAETNA SELECT CHOICE
OH868623302OtherCIGNA
OH90305OtherQUALCHOICE
OH000000230399OtherANTHEM
OH515OtherSUMMACARE
OH5078576OtherAETNA MC & EC
OHQG03984OtherHOMETOWN
OH90305OtherQUALCHOICE
OHQG03984OtherHOMETOWN