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General NPI Number Information
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NPI Number | 1952537219
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Entity Type | Organization
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Legal Business Name | W M D HEART CARE, LLC
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 100 WHISPER LAKE BLVD
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City | MADISON
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State | MS
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Zip | 39110-7881
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Country | US
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Telephone | 601-664-2424
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Fax | 601-664-6675
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Provider Business Mailing Address
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Address Line | PO BOX 1455
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City | MADISON
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State | MS
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Zip | 39130-1455
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Country | US
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Telephone | 601-664-2424
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Fax | 601-664-6675
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Authorized Official
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Title or Position | PHYSICIAN CEO
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Name | ZILIN WANG
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Credential | M.D.
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Telephone | 601-900-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 19834
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License Number State | MS
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