Individual
MR. GREGORY WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13135 LEE JACKSON MEMORIAL HWY, #135, FAIRFAX, VA 22033-1907
(703) 961-0488
(703) 961-9103
Mailing address
13135 LEE JACKSON MEMORIAL HWY, #135, FAIRFAX, VA 22033-1907
(703) 961-0488
(703) 961-9103
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
0101242854
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871778068
—
VA
Enumeration date
01/07/2008
Last updated
08/11/2016
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