Individual
EMMA C WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3006 LINCOLNWAY E, MISHAWAKA, IN 46544-3501
(574) 252-7133
(844) 361-2090
Mailing address
3006 LINCOLNWAY E, MISHAWAKA, IN 46544-3501
(574) 252-7133
(844) 361-2090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02001493
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
002001493
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300037230
—
IN
Enumeration date
06/13/2006
Last updated
08/17/2020
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