MEDICARE: HENRY WANG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013925726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY WANG INC

Provider Business Mailing Address
First Line	:	1346 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8510
Country	:	US
Telephone Number	:	702-889-8355
Fax Number	:	702-889-8699

Provider Business Practice Location Address
First Line	:	1346 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8510
Country	:	US
Telephone Number	:	702-889-8355
Fax Number	:	702-889-8699

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	HENRY WANG
Credential	:	M.D.
Telephone Number	:	702-889-8355

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	08/14/2023

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Directions to “HENRY WANG INC ” Practice Location

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