Provider Demographics
NPI:1518323633
Name:WANG, XUEYANG
Entity Type:Individual
Prefix:
First Name:XUEYANG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60160
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0160
Mailing Address - Country:US
Mailing Address - Phone:704-365-0555
Mailing Address - Fax:704-367-8122
Practice Address - Street 1:135 S SHARON AMITY RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3870
Practice Address - Country:US
Practice Address - Phone:704-365-0555
Practice Address - Fax:704-367-8122
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD93664207W00000X
NC2023-00887207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology