Provider Demographics
NPI:1215043377
Name:WANG, SHUPING (MD)
Entity Type:Individual
Prefix:DR
First Name:SHUPING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SENTARA CIR
Mailing Address - Street 2:STE 102
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5727
Mailing Address - Country:US
Mailing Address - Phone:757-984-9700
Mailing Address - Fax:757-984-9701
Practice Address - Street 1:400 SENTARA CIR
Practice Address - Street 2:STE 305
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-258-2511
Practice Address - Fax:757-258-2728
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101235648207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I42348Medicare UPIN