Individual
DR. JAMES WAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
771 OLD NORCROSS RD, SUITE 340, LAWRENCEVILLE, GA 30046-4386
(678) 376-7399
(678) 376-7398
Mailing address
2001 BUTTERFIELD RD, SUITE 300, DOWNERS GROVE, IL 60515-1050
(630) 725-2730
(844) 205-5691
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
058878
GA
207P00000X
Emergency Medicine Physician
23068
AL
207R00000X
Internal Medicine Physician
058878
GA
2086S0129X
Vascular Surgery Physician
Primary
058878
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003188705B
—
GA
Enumeration date
05/10/2006
Last updated
03/17/2018
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