Provider Demographics
NPI:1275716714
Name:WANG, SHUYAN (MD)
Entity Type:Individual
Prefix:
First Name:SHUYAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8780 PURDUE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6129
Mailing Address - Country:US
Mailing Address - Phone:317-471-8701
Mailing Address - Fax:317-471-8702
Practice Address - Street 1:8780 PURDUE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-6129
Practice Address - Country:US
Practice Address - Phone:317-471-8701
Practice Address - Fax:317-471-8702
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01057545A202C00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner