Individual
JAMES JINGBO WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 AVON BELDEN RD, AVON LAKE, OH 44012-2282
(440) 930-6800
Mailing address
450 AVON BELDEN RD, AVON LAKE, OH 44012-2282
(440) 930-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3507662600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119204
GROUP MEDICAID
—
01
—
103464
KAISER
—
01
—
10814863
CAQH
—
01
—
110216284
RR MEDICARE INDIVIDUAL
—
01
—
1780634279
GROUP NPI
—
05
—
2144932
—
OH
01
—
3610861
GROUP ASC MEDICARE
—
01
—
9273172
GROUP MEDICARE
—
01
—
CA4511
RR MEDICARE GROUP
—
01
—
D368301
GROUP IND DIAGNOSTICS MED
—
Enumeration date
03/09/2006
Last updated
12/09/2019
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