Provider Demographics
NPI:1265448617
Name:WANG, FIKRE S (MD)
Entity Type:Individual
Prefix:DR
First Name:FIKRE
Middle Name:S
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 1:1302 MARENGO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3813
Mailing Address - Country:US
Mailing Address - Phone:504-232-7249
Mailing Address - Fax:
Practice Address - Street 1:1302 MARENGO ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3813
Practice Address - Country:US
Practice Address - Phone:504-232-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD200720208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery