Individual
DR. JILL S WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5515 CLEVELAND AVE, STEVENSVILLE, MI 49127-9670
(269) 429-9644
(269) 429-4002
Mailing address
5515 CLEVELAND AVE, STEVENSVILLE, MI 49127-9670
(269) 429-9644
(269) 429-4002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301085238
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101110672
BLUE CROSS PIN
MI
05
—
4725409
—
MI
01
—
P00245264
RAILROAD MEDICARE
MI
Enumeration date
06/15/2006
Last updated
03/07/2023
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