MEDICARE: ANDREA SUSAN 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	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	6166	AK

General Provider Information

NPI Number	:	1780616680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA SUSAN WANG MD

Provider Business Mailing Address
First Line	:	PO BOX 91058
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99509-1058
Country	:	US
Telephone Number	:	907-243-0133
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 L ST STE 300
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-3359
Country	:	US
Telephone Number	:	907-243-0133
Fax Number	:

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	01/06/2026

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