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General NPI Number Information
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NPI Number | 1245473230
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Entity Type | Individual
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Provider Name | ZHIYU WANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 1628 S MILDRED ST STE 104
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City | TACOMA
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State | WA
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Zip | 98465-1627
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Country | US
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Telephone | 253-565-6777
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Fax | 253-565-8777
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Provider Business Mailing Address
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Address Line | 1628 S MILDRED ST STE 104
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City | TACOMA
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State | WA
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Zip | 98465-1627
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Country | US
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Telephone | 253-565-6777
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Fax | 253-565-8777
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60209366
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD60209366
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License Number State | WA
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