Provider Demographics
NPI:1063479756
Name:WANG, LINDA C (MD JD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:WANG
Suffix:
Gender:F
Credentials:MD JD
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Mailing Address - Street 1:1205 YORK RD STE 39A
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6219
Mailing Address - Country:US
Mailing Address - Phone:443-288-1870
Mailing Address - Fax:443-288-6639
Practice Address - Street 1:1205 YORK RD STE 39A
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6219
Practice Address - Country:US
Practice Address - Phone:443-288-1870
Practice Address - Fax:443-288-6639
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0072992207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology