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NPI Code Detail

MEDICARE: HONG CHU WANG M.D.

MEDICARE: HONG CHU WANG M.D.
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
12085R0001XRadiation Oncology Physician22834WI

Other Identifiers

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

General Provider Information

NPI Number : 1114938156
Entity Type Code : Individual
Provider Name (Legal Business Name) : HONG CHU WANG M.D.
Provider Business Mailing Address
First Line : 200 E WASHINGTON ST
Second Line : P O BOX 8031
City : APPLETON
State : WI
Zip : 54911-5490
Country : US
Telephone Number : 800-236-1428
Fax Number : 920-739-0124
Provider Business Practice Location Address
First Line : 480 E DIVISION ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-3734
Country : US
Telephone Number : 920-926-4101
Fax Number : 920-926-4190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 07/08/2007

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