Provider Demographics
NPI:1578962239
Name:WANG, MINGXIANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:MINGXIANG
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5968 TURNABOUT LN APT 6
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3024
Mailing Address - Country:US
Mailing Address - Phone:509-592-7335
Mailing Address - Fax:
Practice Address - Street 1:5968 TURNABOUT LN APT 6
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3024
Practice Address - Country:US
Practice Address - Phone:509-592-7335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist