MEDICARE: DAVID S 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	2084N0400X	Neurology Physician	MD-53064	IA

General Provider Information

NPI Number	:	1972063709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID S WANG MD

Provider Business Mailing Address
First Line	:	11100 EUCLID AVE
Second Line	:	DEPARTMENT OF NEUROLOGY
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1716
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 UNIVERSITY AVE STE 210
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8201
Country	:	US
Telephone Number	:	515-241-2080
Fax Number	:

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

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	07/03/2024

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