Healthcare Provider Details

I. General information

NPI: 1336875236
Provider Name (Legal Business Name): JINPING WANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 W PATRICK ST STE 5
FREDERICK MD
21701-4027
US

IV. Provider business mailing address

1234 OAKWOOD DR
FREDERICK MD
21701-4256
US

V. Phone/Fax

Practice location:
  • Phone: 240-578-3250
  • Fax:
Mailing address:
  • Phone: 561-298-8581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU03041
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: