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NPI Code Detail

MEDICARE: DR. DAVID HOWLAND WANG MD

MEDICARE: DR. DAVID HOWLAND 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
1207QS0010XSports Medicine (Family Medicine) Physician33841MN
2207QS0010XSports Medicine (Family Medicine) Physician47308CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548243066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID HOWLAND WANG MD
Provider Business Mailing Address
First Line : 1290 SILAS DEANE HWY
Second Line : HARTFORD HEALTHCARE-CVO
City : WETHERSFIELD
State : CT
Zip : 06109-4337
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 275 MOUNT CARMEL AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-1961
Country : US
Telephone Number : 203-582-8742
Fax Number : 203-582-8924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 09/26/2022

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