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Individual

THERESA WANG

Active
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Individual

THERESA WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
70000
GA
208200000X
Plastic Surgery Physician
MT188087
PA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
070000
GA

Other

Enumeration date
12/28/2006
Last updated
07/29/2016
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