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General NPI Number Information
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NPI Number | 1881745982
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Entity Type | Organization
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Legal Business Name | MIN GUANG WANG PLLC
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2600 WILSON ST
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City | MILES CITY
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State | MT
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Zip | 59301-5094
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Country | US
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Telephone | 360-736-0051
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Fax |
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Provider Business Mailing Address
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Address Line | 167 RIVER HEIGHTS RD
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City | CENTRALIA
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State | WA
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Zip | 98531-9025
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Country | US
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Telephone | 360-736-0051
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MIN-GUANG WANG
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Credential | M.D.
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Telephone | 360-736-0051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10713
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License Number State | MT
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