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Individual

DR. KYNE MARTIN WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4022 FREEDOM LAKE DR, DURHAM, NC 27704
(919) 477-2202
(919) 471-2270
Mailing address
4022 FREEDOM LAKE DR, DURHAM, NC 27704
(919) 477-2202
(919) 471-2270

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9901075
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1216U
BCBS STATE FEDERAL NC HEA
NC
01
1255307
UNITED HEALTHCARE
01
2242290
AETNA
01
273703
MAMSI ALLIANCE
01
88979
MEDCOST
01
8912160
CAROLINA ACCESS NC
05
891216U
NC
Enumeration date
04/22/2006
Last updated
07/12/2007
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