Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | D59036 | MD |
N | 208000000X | Pediatrician | D59036 | MD |
NPI | 1811923907 |
---|---|
Provider Name | Tao Wang |
First Address | Baltimore, MD 21264-4316 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H64536 | (02) | MD |