Individual
LI FEN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9012 CONNECTICUT DR, MERRILLVILLE, IN 46410-7170
(219) 769-6177
(219) 769-1374
Mailing address
9012 CONNECTICUT DR, MERRILLVILLE, IN 46410-7170
(219) 769-6177
(219) 769-1374
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01029282A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000095392
ANTHEM/BLUE CROSS BLUE SH
IN
01
—
91107987
BCBS OF IL
IN
Enumeration date
04/03/2006
Last updated
10/07/2014
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