Healthcare Provider Details

I. General information

NPI: 1447470836
Provider Name (Legal Business Name): HUI-HUNG WANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 CAPITAL CIR NE
TALLAHASSEE FL
32308-4104
US

IV. Provider business mailing address

7128 BEECH RIDGE TRL
TALLAHASSEE FL
32312-3642
US

V. Phone/Fax

Practice location:
  • Phone: 850-385-8961
  • Fax:
Mailing address:
  • Phone: 850-893-0257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME 33727
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: