MEDICARE: DR. CHEN 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	207Q00000X	Family Medicine Physician	2023-00766	NC

General Provider Information

NPI Number	:	1659752764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHEN WANG MD

Provider Business Mailing Address
First Line	:	3125 SPRINGBANK LN STE B
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3379
Country	:	US
Telephone Number	:	704-709-3351
Fax Number	:

Provider Business Practice Location Address
First Line	:	3125 SPRINGBANK LN STE B
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3379
Country	:	US
Telephone Number	:	704-709-3351
Fax Number	:

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

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	12/19/2025

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