Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | D0072992 | MD |
NPI | 1063479756 |
---|---|
Provider Name | Linda C Wang |
First Address | Lutherville, MD 21093-6219 |
Second Address | Lutherville, MD 21093-6219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 27/12/2016 |