Provider Demographics
NPI:1306903364
Name:CHARLES WANG, MD, PA
Entity type:Organization
Organization Name:CHARLES WANG, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:REFALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-655-1500
Mailing Address - Street 1:1700 WAWASET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2142
Mailing Address - Country:US
Mailing Address - Phone:302-655-1500
Mailing Address - Fax:
Practice Address - Street 1:1700 WAWASET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-2142
Practice Address - Country:US
Practice Address - Phone:302-655-1500
Practice Address - Fax:302-655-4084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000188202Medicaid
NJ3885003Medicaid
PA0018777480001Medicaid
DE0000188202Medicaid
NJ3885003Medicaid