Provider Demographics
NPI:1063634673
Name:WANG, JEFF FILBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:FILBERT
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 1:1205 WILDHORSE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1350
Mailing Address - Country:US
Mailing Address - Phone:402-598-2672
Mailing Address - Fax:
Practice Address - Street 1:1205 WILDHORSE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1350
Practice Address - Country:US
Practice Address - Phone:402-598-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011012563207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology