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Individual

YANG WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8300 CONSTITUTION AVE NE, PMG AT 8300 CONSTITUTION POB, ALBUQUERQUE, NM 87110-7613
(505) 559-6100
(505) 559-6101
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2015-0604
NM
207RH0003X
Hematology & Oncology Physician
Primary
MD2015-0604
NM

Other

Enumeration date
02/11/2011
Last updated
09/03/2015
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