MEDICARE: DR. JULIE 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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	MD433415	PA
2	207R00000X	Internal Medicine Physician	MD433415	PA

General Provider Information

NPI Number	:	1578725339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE WANG MD

Provider Business Mailing Address
First Line	:	1601 CHERRY ST
Second Line	:	SUITE 11511
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-1320
Country	:	US
Telephone Number	:	215-255-7822
Fax Number	:	215-255-7825

Provider Business Practice Location Address
First Line	:	10 SHURS LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-2123
Country	:	US
Telephone Number	:	215-482-0899
Fax Number	:

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

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	11/03/2015

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