Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME0082367 | FL |
NPI | 1053347906 |
---|---|
Provider Name | Dr. Michael Yung-Shun Wang |
First Address | Miami, FL 33136 |
Second Address | Miami, FL 33136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A656110 | (05) | CA |
278204900 | (05) | FL |
90532 | (02) | FL |
H24416 | (02) | CA |