Provider Demographics
NPI:1376508499
Name:GIEP, BANG N (MD)
Entity type:Individual
Prefix:DR
First Name:BANG
Middle Name:N
Last Name:GIEP
Suffix:
Gender:M
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:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:853 N CHURCH ST STE 600
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3070
Practice Address - Country:US
Practice Address - Phone:864-583-4556
Practice Address - Fax:864-560-0625
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17713174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG027656162OtherMEDICARE PIN
SC177132Medicaid
SCSCD4663365OtherMEDICARE PIN