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NPI Code Detail

MEDICARE: DR. MARVIN LEI WANG MD

MEDICARE: DR. MARVIN LEI 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
1208000000XPediatrics Physician151143MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1J17460OTHERMABCBS MA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3151143OTHERMATUFTS HEALTH PLAN

General Provider Information

NPI Number : 1497745046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARVIN LEI WANG MD
Provider Business Mailing Address
First Line : 330 MOUNT AUBURN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-5597
Country : US
Telephone Number : 617-492-3500
Fax Number :
Provider Business Practice Location Address
First Line : 330 MOUNT AUBURN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-5597
Country : US
Telephone Number : 617-492-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 06/05/2025

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