Provider Demographics
NPI:1669450219
Name:WANG, ROBERT C (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:WANG
Suffix:
Gender:M
Credentials:MD, FACS
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Mailing Address - Street 1:2040 W CHARLESTON BLVD
Mailing Address - Street 2:#601
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2227
Mailing Address - Country:US
Mailing Address - Phone:702-671-2298
Mailing Address - Fax:702-384-7506
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:#112
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-562-1777
Practice Address - Fax:702-671-6481
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV8396207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCS09098OtherPHARMACY/CDS
NV002019934Medicaid
NV002019934Medicaid
NV002019934Medicaid
NVWQBHV30170Medicare ID - Type Unspecified