Healthcare Provider Details

I. General information

NPI: 1518101823
Provider Name (Legal Business Name): MING HSIEN WANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N WOLFE ST
BALTIMORE MD
21287-0011
US

IV. Provider business mailing address

PO BOX 64255
BALTIMORE MD
21264-4255
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-2914
  • Fax:
Mailing address:
  • Phone: 410-955-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberA98677
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberD69624
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberD69624
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: