Provider Demographics
NPI:1053313551
Name:WANG, HAI-SHIUH M (MD)
Entity Type:Individual
Prefix:DR
First Name:HAI-SHIUH
Middle Name:M
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DUTTON DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1818
Mailing Address - Country:US
Mailing Address - Phone:330-746-7691
Mailing Address - Fax:330-743-8368
Practice Address - Street 1:10 DUTTON DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1818
Practice Address - Country:US
Practice Address - Phone:330-746-7691
Practice Address - Fax:330-743-8368
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-039639207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000126317OtherANTHEM
OH0800319OtherUNITED HEALTHCARE
PA0009962430001OtherMEDICAID
OH0328765Medicaid
OH82798OtherQUALCHOICE
OH180011154OtherRAILROAD MEDICARE
OH4099081OtherAETNA
OHZ39639OtherSUMMACARE
OH069918OtherKEYSTONE
OH0328765Medicaid
OH0426721Medicare PIN