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General NPI Number Information
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NPI Number | 1710897137
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Entity Type | Individual
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Provider Name | KEVIN HONNIE WANG
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Gender | Male
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 51 E 4TH ST
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City | WINSTON SALEM
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State | NC
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Zip | 27101-4109
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Country | US
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Telephone | 919-348-7407
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Fax |
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Provider Business Mailing Address
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Address Line | 409 DESHIRE MIST LN
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City | CARY
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State | NC
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Zip | 27519-6944
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618003677
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License Number State | VA
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