Individual
WUQIANG FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
(610) 258-3047
Mailing address
399 REVOLUTION DR STE 580, SOMERVILLE, MA 02145-1572
(610) 258-1400
(610) 258-3047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD455239
PA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD455239
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030442710003
—
PA
Enumeration date
04/01/2012
Last updated
03/11/2026
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