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Individual

DR. LI JUAN WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
593 EDDY ST, DEPARTMENT OF PATHOLOGY APC-12, PROVIDENCE, RI 02903-4923
(401) 444-2517
(401) 444-8514
Mailing address
593 EDDY ST, DEPARTMENT OF PATHOLOGY APC-12, PROVIDENCE, RI 02903-4923
(401) 444-2517
(401) 444-8514

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD10437
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7009559
RI
Enumeration date
05/31/2006
Last updated
07/21/2014
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