Healthcare Provider Details

I. General information

NPI: 1427179225
Provider Name (Legal Business Name): LUKE WANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1800 ORLEANS ST
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-7610
  • Fax:
Mailing address:
  • Phone: 410-955-7610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD0083319
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0083319
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: