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General NPI Number Information
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NPI Number | 1508738113
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Entity Type | Individual
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Provider Name | XIANGYU WANG RPH
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Gender | Male
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 2210 EDISON RD
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City | SOUTH BEND
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State | IN
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Zip | 46615-3514
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Country | US
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Telephone | 574-472-3234
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Fax |
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Provider Business Mailing Address
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Address Line | 7411 ASPECT DR UNIT 117
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City | GRANGER
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State | IN
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Zip | 46530-7755
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Country | US
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Telephone | 929-307-7487
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26031467A
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License Number State | IN
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