Provider Demographics
NPI:1629036843
Name:WANG, VALERIE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:MARIE
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9260 W SUNSET RD
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4903
Mailing Address - Country:US
Mailing Address - Phone:702-255-3547
Mailing Address - Fax:702-255-3547
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 610
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-941-9600
Practice Address - Fax:808-941-2211
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10283207V00000X
NV17517207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB22805-2OtherHMSA
HIH54691Medicare ID - Type Unspecified
HIB22805-2OtherHMSA