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General NPI Number Information
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NPI Number | 1013424936
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Entity Type | Individual
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Provider Name | KEMENG WANG OD
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Gender | Female
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Dates
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Enumeration Date | 12/30/2017
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 5150 BUFORD HWY NE STE D120
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City | DORAVILLE
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State | GA
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Zip | 30340-1170
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Country | US
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Telephone | 770-234-9249
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Fax | 770-234-0306
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Provider Business Mailing Address
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Address Line | 5150 BUFORD HWY NE STE D120
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City | DORAVILLE
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State | GA
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Zip | 30340-1170
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Country | US
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Telephone | 770-234-9249
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003029
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License Number State | GA
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