=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679367783
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HUAN WANG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2025
-----------------------------------------------------
Last Update Date | 04/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6410 ROCKLEDGE DR STE 418
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20817-1842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-530-5308
-----------------------------------------------------
Fax | 301-564-5808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6410 ROCKLEDGE DR STE 418
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20817-1842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-530-5308
-----------------------------------------------------
Fax | 301-530-5308
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | U03205
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------