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General NPI Number Information
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NPI Number | 1336566561
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Entity Type | Individual
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Provider Name | ANDREW WANG D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 1057 MORNINGSIDE DR
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City | PERRY
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State | GA
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Zip | 31069-2903
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Country | US
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Telephone | 478-218-1801
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 N POINT PKWY STE 300
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City | ALPHARETTA
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State | GA
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Zip | 30022-4102
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 079256
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License Number State | GA
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