Individual
YI WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2970 W US HIGHWAY 90 STE 110, LAKE CITY, FL 32055-4703
(386) 247-6915
(386) 247-6915
Mailing address
2970 W US HIGHWAY 90 STE 110, LAKE CITY, FL 32055-4703
(386) 247-6915
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101258942
VA
208600000X
Surgery Physician
Primary
136863
FL
208600000X
Surgery Physician
MT216950
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT216590
PA
Other
Enumeration date
03/29/2013
Last updated
10/24/2023
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