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Organization
WANGMED
Active
Organization
WANGMED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY YU-WAH WANG D.O. (OWNER)
(310) 455-7409
Entity
Organization
Contact information
Practice address
7802 EARLY MORNING ST, FULTON, MD 20759-2518
(410) 335-0008
(410) 335-1133
Mailing address
10845 PHILADELPHIA RD, WHITE MARSH, MD 21162-1717
(410) 335-0008
(410) 335-1133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155274
MEDICARE
MD
01
—
417555700
MEDICAL ASSISTANCE
MD
01
—
DP0510
RAILROAD MEDICARE
GA
01
—
DW1WBY
CAREFIRST
MD
01
—
P424
CAREFIRST
DC
Enumeration date
12/12/2008
Last updated
10/06/2009
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