CHARLIE WEICHEN FANG (NPI# 1609962521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609962521 |
| Entity Type | Individual |
| Full Name | CHARLIE WEICHEN FANG |
| Credential | MD |
| Practice Address |
707 Old Ellijay Road Chatsworth GA 30705 |
| Mailing Address |
Po Box 636019 Cincinnati OH 45263-6019 |
| Practice Telephone | 7065172093 |
| Mailing Telephone | 8005777707 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 055513 | GA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 38728 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3898281 | 05 | |
| TN | RAILROAD | P00231542 | 01 |
| GA | RAILROAD | P00288351 | 01 |
| TN | BCBSTN | 4087933 | 01 |
| KY | 64088644 | 05 |
| Street Address |
707 OLD ELLIJAY ROAD |
| City | CHATSWORTH |
| State | GA |
| Zip Code | 30705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821582784 | Kayla Michelle Khan | Dentist | 221 N. 4th Avenue, Chatsworth, GA 30705 | 2018-06-14 |
| 1578079869 | Professional Eye Associates, Inc. | Eyewear Supplier (Equipment, not the service) | 113 West Pine Street, Chatsworth, GA 30705 | 2017-12-21 |
| 1518472778 | Rebecca Annette Lunsford | Case Manager/Care Coordinator | 165 Freedom Way, Chatsworth, GA 30705 | 2017-12-11 |
| 1306214630 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 502 Gi Maddox Parkway, Chatsworth, GA 30705 | 2015-09-03 |
| 1003231416 | Jessica Sanders | Nurse Practitioner | 800 Gi Maddox Pwky, Chatsworth, GA 30705 | 2014-02-20 |
| 1063731560 | Travis Mckie-voerste | Counselor | 96 Terrace Ct, Chatsworth, GA 30705 | 2010-05-24 |
| 1619941689 | Murray County Board of Health | Public Health or Welfare | 709 Dalton-ellijay Highway, Chatsworth, GA 30705 | 2006-02-15 |
| 1780671974 | Trom Enterprises, Inc. | Pharmacy | 101 Murray Plaza, Chatsworth, GA 30705 | 2005-10-03 |
| 1518953785 | Yara Fattouh | Family Medicine | 1111 Hwy 76, Chatsworth, GA 30705 | 2005-09-23 |
| 1700355070 | Cortney Dunn | Licensed Practical Nurse | 1289 Gi Maddox Pkwy, Chatsworth, GA 30705 | 2018-11-16 |
| Find all providers in zip 30705 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336124072 | Penny Lynn Charrance | Emergency Medicine | 707 Old Dalton Ellijay Rd, Chatsworth, GA 30705-2029 | 2005-12-14 |
| 1043783970 | Murray Emergency Physicians, LLC | Emergency Medicine | 707 Old Dalton Ellijay Rd, Chatsworth, GA 30705-2029 | 2019-01-03 |
| 1639621485 | Gordon Emergency Physicians, LLC | Emergency Medicine | 707 Old Dalton Ellijay Rd, Chatsworth, GA 30705-2029 | 2016-10-27 |
| 1245570332 | Fort Mountain Emergency Physicians, LLC | Emergency Medicine | 707 Old Dalton Ellijay Rd, Chatsworth, GA 30705-2029 | 2013-02-26 |
| 1861445793 | Dorel Bidiuc | Emergency Medicine | 707 Old Dalton Ellijay Rd, Chatsworth, GA 30705-2029 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081657 | Rtw Health Services LLC | Emergency Medicine | 1951 Lenox Rd Ne, Atlanta, GA 30306-3059 | 2020-10-21 |
| 1790396984 | Chisholm Trail Urgent Care Pllc | Emergency Medicine | 11 Tsys Way, Columbus, GA 31901 | 2020-08-12 |
| 1275141467 | Viral Solutions LLC | Emergency Medicine | 1752 Moonstone Ct, Decatur, GA 30033-1411 | 2020-07-14 |
| 1376102830 | John Edward Cooke | Emergency Medicine | 2411 Tuxedo Ln Nw, Marietta, GA 30064-1898 | 2019-06-10 |
| 1538646526 | Edwige Goby Konwo-tayo | Emergency Medicine | 1183 S Hairston Rd Ste A, Stone Mountain, GA 30088-2796 | 2018-07-23 |
| 1548763899 | South Georgia Er Services, LLC | Emergency Medicine | 313 Carrick Way, Macon, GA 31210-4952 | 2018-03-13 |
| 1922517945 | Infinity Wellness Solutions LLC | Emergency Medicine | 3240 Pointe Parkway, Suite 100, Norcross, GA 30092 | 2017-09-21 |
| 1528594314 | Kendra Chantelle Krieg | Emergency Medicine | 185 Anniversary Ln, Acworth, GA 30102 | 2017-05-11 |
| 1114450806 | Peyton Jones Syed | Emergency Medicine | 13765 Brittle Rd, Alpharetta, GA 30004-3592 | 2017-04-10 |
| 1437690658 | Miles Anthony Medina | Emergency Medicine | 1133 Eagles Landing Pkwy # Er, Stockbridge, GA 30281-5085 | 2017-03-20 |
| Find all providers with the same taxonomy | ||||
| City | CHATSWORTH |
| Zip Code | 30705 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.