Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301081779 | MI |
N | 111NI0900X | Internist | 4301081779 | MI |
N | 207RN0300X | Nephrologist | 4301081779 | MI |
Y | 207RN0300X | Nephrologist | 51821 | MN |
NPI | 1013031749 |
---|---|
Provider Name | Jeffrey Hsing-Che Wang |
First Address | Minneapolis, MN 55415-1623 |
Second Address | Minneapolis, MN 55415-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 06/08/2015 |