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NPI Code Detail

MEDICARE: SHISAN WANG ACUPUNCTURIST

MEDICARE: SHISAN WANG ACUPUNCTURIST
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
1171100000XAcupuncturist67NC

General Provider Information

NPI Number : 1982046330
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHISAN WANG ACUPUNCTURIST
Provider Business Mailing Address
First Line : 3705 LATROBE DR STE 320
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-4823
Country : US
Telephone Number : 704-366-6818
Fax Number : 704-366-6818
Provider Business Practice Location Address
First Line : 3705 LATROBE DR STE 320
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-4823
Country : US
Telephone Number : 704-366-6818
Fax Number : 704-366-6818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2013
Last Update Date : 07/26/2013

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Directions to “ SHISAN WANG ACUPUNCTURIST” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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