Individual
DR. FAJUN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-4845
Mailing address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
2021045404
MO
2084N0400X
Neurology Physician
Primary
2021045404
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2016
Last updated
01/13/2023
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