Provider Demographics
NPI:1447267281
Name:KORANG, VICTOR EBED (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:EBED
Last Name:KORANG
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 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-774-3740
Mailing Address - Fax:336-774-3780
Practice Address - Street 1:4611 YADKINVILLE RD
Practice Address - Street 2:
Practice Address - City:PFAFFTOWN
Practice Address - State:NC
Practice Address - Zip Code:27040-8622
Practice Address - Country:US
Practice Address - Phone:336-718-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270945207R00000X
CT044428207R00000X
NC2010-00509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTI63498Medicare UPIN
CT110010068Medicare PIN