Individual
DR. SOPHIA WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
355 W 16TH ST, INDIANAPOLIS, IN 46202-2207
(317) 963-7300
(317) 963-7325
Mailing address
250 N SHADELAND AVE, SUITE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01074927A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201305620
—
IN
Enumeration date
05/29/2008
Last updated
11/12/2021
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