Healthcare Provider Details

I. General information

NPI: 1346876356
Provider Name (Legal Business Name): YANNAN WANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 WATERS AVE STE 300
SAVANNAH GA
31404-1170
US

IV. Provider business mailing address

4790 WATERS AVE STE 300
SAVANNAH GA
31404-1170
US

V. Phone/Fax

Practice location:
  • Phone: 844-706-8773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number113033
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: