Organization
FAMILY MEDICINE & WEIGHT LOSS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAIQIU E WANG MD (SOLE MEMBER)
(901) 842-1473
Entity
Organization
Contact information
Practice address
420 S GERMANTOWN PKWY, SUITE 105B, CORDOVA, TN 38018-4387
(901) 842-1473
Mailing address
420 S GERMANTOWN PKWY, SUITE 105B, CORDOVA, TN 38018-4387
(901) 842-1473
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37771
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6012116
BCBS
TN
Enumeration date
05/12/2014
Last updated
05/13/2014
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