Healthcare Provider Details

I. General information

NPI: 1518036433
Provider Name (Legal Business Name): RUILIN WANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4424 S 86TH ST
LINCOLN NE
68526-9225
US

IV. Provider business mailing address

2222 S 16TH ST SUITE 400A
LINCOLN NE
68502-3796
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8500
  • Fax: 402-483-8501
Mailing address:
  • Phone: 402-483-8590
  • Fax: 402-483-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20889
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: