Provider Demographics
NPI:1114036787
Name:WANG, HSIN (MD)
Entity Type:Individual
Prefix:DR
First Name:HSIN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5686 CHERRY LANE
Mailing Address - Street 2:
Mailing Address - City:W. BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324
Mailing Address - Country:US
Mailing Address - Phone:248-681-7794
Mailing Address - Fax:
Practice Address - Street 1:2520 S TELEGRAPH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0285
Practice Address - Country:US
Practice Address - Phone:248-335-9207
Practice Address - Fax:248-335-2394
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074504207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH69796Medicare UPIN
MION54630Medicare ID - Type Unspecified