Individual
ALICE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6611 CLYO RD STE F, DAYTON, OH 45459-2785
(937) 208-5300
(937) 208-5650
Mailing address
6611 CLYO RD STE F, DAYTON, OH 45459-2785
(937) 208-5300
(937) 208-5650
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2020-01877
NC
208600000X
Surgery Physician
Primary
35.143080
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0455709
—
OH
Enumeration date
04/01/2013
Last updated
09/20/2021
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