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General NPI Number Information
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NPI Number | 1316498306
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Entity Type | Organization
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Legal Business Name | LINDA C WANG, MD, LLC
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 1205 YORK RD STE 39A
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6219
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Country | US
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Telephone | 443-288-1870
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Fax | 443-288-6639
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Provider Business Mailing Address
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Address Line | 1205 YORK RD STE 39A
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6219
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Country | US
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Telephone | 443-288-1870
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Fax | 443-288-6639
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. LINDA C WANG
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Credential | MD
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Telephone | 443-288-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D0072992
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License Number State | MD
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