Individual
ZHIQIANG BRAD WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-2738
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-2738
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
ME107392
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301112003
MI
390200000X
Student in an Organized Health Care Education/Training Program
BP10023529
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023836-00
—
FL
05
—
102125880A
—
GA
Enumeration date
11/25/2008
Last updated
11/08/2018
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