Individual
DR. JIMMY WENJE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
88 E NEWTON ST, BOSTON, MA 02118-2308
(617) 638-6610
(617) 638-6616
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
230424
MA
2085R0202X
Diagnostic Radiology Physician
Primary
230424
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075214A
—
MA
Enumeration date
10/05/2006
Last updated
07/10/2014
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