Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D46749 | MD |
Y | 208600000X | Surgeon | D46749 | MD |
N | 2086S0102X | Surgical Critical Care | MD21317 | OR |
N | 2086S0102X | Surgical Critical Care | MD432263 | PA |
N | 2086S0127X | Trauma Surgeon | 0101238702 | VA |
N | 2086S0127X | Trauma Surgeon | 28810 | OK |
NPI | 1063588945 |
---|---|
Provider Name | Dennis S Wang |
First Address | Baltimore, MD 21297-3086 |
Second Address | Frederick, MD 21701-4586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
271010 | (05) | OR |
807433600 | (05) | ID |
8453565 | (05) | WA |