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General NPI Number Information
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NPI Number | 1639882293
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Entity Type | Organization
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Legal Business Name | JOHN WANG OPHTHALMOLOGY LLC
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 34501 AURORA RD STE 302
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City | SOLON
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State | OH
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Zip | 44139-3848
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Country | US
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Telephone | 585-690-6199
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 WARRENSVILLE CENTER RD APT 605
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-6372
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Country | US
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Telephone | 585-690-6199
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN WANG
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Credential | MD
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Telephone | 585-690-6199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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