Individual
DR. EILEEN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 PROFESSIONAL DR STE 300, LAWRENCEVILLE, GA 30046-7670
(678) 323-1041
(770) 962-0012
Mailing address
3225 CUMBERLAND BLVD SE STE 900, ATLANTA, GA 30339-5971
(404) 351-2220
(404) 352-5392
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
081570
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003212185A
—
GA
01
—
G07712A
MEDICARE PTAN
GA
Enumeration date
06/28/2007
Last updated
02/28/2019
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