Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57.010623 | OH |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 8515 | SD |
NPI | 1043427990 |
---|---|
Provider Name | Katherine Wang |
First Address | Sioux Falls, SD 57118-6370 |
Second Address | Sioux Falls, SD 57105-1007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 09/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2825358 | (05) | OH |
6702750 | (05) | SD |