Healthcare Provider Details

I. General information

NPI: 1114036787
Provider Name (Legal Business Name): HSIN WANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 S TELEGRAPH RD SUITE 200
BLOOMFIELD HILLS MI
48302-0285
US

IV. Provider business mailing address

5686 CHERRY LANE
W. BLOOMFIELD MI
48324
US

V. Phone/Fax

Practice location:
  • Phone: 248-335-9207
  • Fax: 248-335-2394
Mailing address:
  • Phone: 248-681-7794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301074504
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: