Physician Compare National (NPI:1801089099)

HEALTHCARE PROVIDER: WENLI WANG MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1801089099
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668518937
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100719000500
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WANG
	Individual professional last name
Provider First Name	WENLI
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	FORT OGLETHORPE EMERGENCY PHYSICIANS GROUP LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8527323633
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	100 GROSS CRESCENT CIR
	Group Practice or individual's line 1 address
City	FORT OGLETHORPE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	307423643
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7068582000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	010065
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RUSSELL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360055
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	STEWARD TRUMBULL MEMORIAL HOSPITAL, INC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360075
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	UH REGIONAL HOSPITALS
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110236
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	CHI MEMORIAL HOSPITAL - GEORGIA
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	010008
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	CRENSHAW COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1801089099)

HEALTHCARE PROVIDER: WENLI WANG MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information