MEDICARE: DR. HUIJIAN JAMES 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
1	207RC0000X	Cardiovascular Disease Physician	35.089536	OH
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	35.089536	OH
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME101341	FL
4	207RC0000X	Cardiovascular Disease Physician	ME101341	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043488661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUIJIAN JAMES WANG MD

Provider Business Mailing Address
First Line	:	PO BOX 291427
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-1427
Country	:	US
Telephone Number	:	386-672-1023
Fax Number	:	386-263-2996

Provider Business Practice Location Address
First Line	:	1240 W GRANADA BLVD FL 2
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5915
Country	:	US
Telephone Number	:	386-672-1023
Fax Number	:	386-263-2996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2008
Last Update Date	:	06/02/2022

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