Individual
LILY C WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PHD
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 773-1728
Mailing address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 773-1728
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
155662
CA
2088P0231X
Pediatric Urology Physician
A155662
CA
2088P0231X
Pediatric Urology Physician
Primary
MD26142
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2010
Last updated
09/12/2022
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