Healthcare Provider Details

I. General information

NPI: 1578603338
Provider Name (Legal Business Name): WENDY WANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 16TH AVE N STE G
MYRTLE BEACH SC
29577-3537
US

IV. Provider business mailing address

608 16TH AVE N STE G
MYRTLE BEACH SC
29577-3537
US

V. Phone/Fax

Practice location:
  • Phone: 843-501-1099
  • Fax:
Mailing address:
  • Phone: 843-501-1099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD35578
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number235726
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: