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General NPI Number Information
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NPI Number | 1013931039
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Entity Type | Individual
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Provider Name | SAMUEL WANG MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 3288 MOANALUA RD
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City | HONOLULU
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State | HI
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Zip | 96819-1469
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Country | US
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Telephone | 808-432-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3288 MOANALUA RD
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City | HONOLULU
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State | HI
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Zip | 96819-1469
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Country | US
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Telephone | 808-432-0000
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A69484
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD-21142
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | A69484
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | MD-21142
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License Number State | HI
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