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NPI Code Detail

MEDICARE: KAYLLIE WANG MD

MEDICARE:   KAYLLIE  WANG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics PhysicianMD466540PA

General Provider Information

NPI Number : 1033564372
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLLIE WANG MD
Provider Business Mailing Address
First Line : 1100 WASHINGTON AVE STE 215
Second Line :
City : CARNEGIE
State : PA
Zip : 15106-3616
Country : US
Telephone Number : 412-278-3310
Fax Number :
Provider Business Practice Location Address
First Line : 1580 MCLAUGHLIN RUN RD STE 208
Second Line :
City : UPPER ST CLAIR
State : PA
Zip : 15241-3100
Country : US
Telephone Number : 412-221-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2016
Last Update Date : 01/05/2023

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Directions to “ KAYLLIE WANG MD” Practice Location

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