Healthcare Provider Details

I. General information

NPI: 1053520601
Provider Name (Legal Business Name): HONGPING WANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HONGPING BOUCHER MD

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 UPHAM DR 140
COLUMBUS OH
43210-1250
US

IV. Provider business mailing address

226 W 8TH AVE #2
COLUMBUS OH
43201-6312
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4540
  • Fax:
Mailing address:
  • Phone: 603-233-3798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: