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Individual

LAWRENCE L WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
321 MITCHELL AVE, BATESVILLE, IN 47006-8909
(513) 965-8041
(513) 965-8091
Mailing address
PO BOX 428704, CINCINNATI, OH 45242-8704
(513) 965-8041
(513) 965-8091

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01045256A
IN
2085R0202X
Diagnostic Radiology Physician
01045256A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20009930A
IN
Enumeration date
05/22/2006
Last updated
07/17/2013
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