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General NPI Number Information
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NPI Number | 1629486881
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Entity Type | Individual
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Provider Name | LIJUN WANG MD, PHD, DABMGG
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Gender | Male
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 719 THOMPSON LN
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City | NASHVILLE
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State | TN
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Zip | 37204-3609
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Country | US
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Telephone | 615-875-0233
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Fax |
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Provider Business Mailing Address
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Address Line | 719 THOMPSON LN
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City | NASHVILLE
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State | TN
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Zip | 37204-3609
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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 | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number | 0000026526
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License Number State | TN
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