Individual
DR. RALPH WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8005
(616) 840-9642
Mailing address
2180 WEST MANCHESTER RD, WHEATON, IL 60187
(708) 567-4538
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036120935
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301117210
MI
208100000X
Physical Medicine & Rehabilitation Physician
BP10023392
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036120935-1
—
IL
Enumeration date
03/17/2008
Last updated
03/31/2021
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