Provider Demographics
NPI:1538503016
Name:WANG, CIXIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CIXIN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 WILMETT RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2520
Mailing Address - Country:US
Mailing Address - Phone:402-310-0041
Mailing Address - Fax:
Practice Address - Street 1:3234 BENJAMIN BUILDING UNIVERSITY OF MARYLAND
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-1832
Practice Address - Country:US
Practice Address - Phone:301-405-7914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05035103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist