Healthcare Provider Details

I. General information

NPI: 1619662368
Provider Name (Legal Business Name): DAVID COPE WANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST
CHATTANOOGA TN
37403-2173
US

IV. Provider business mailing address

975 E 3RD ST
CHATTANOOGA TN
37403-2173
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-7628
  • Fax:
Mailing address:
  • Phone: 423-778-7628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number76332
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: