Provider Demographics
NPI:1679769483
Name:WANG, MINSHENG (MD)
Entity Type:Individual
Prefix:
First Name:MINSHENG
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 LAWRENCEVILLE HWY NW STE B
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3667
Mailing Address - Country:US
Mailing Address - Phone:678-691-0839
Mailing Address - Fax:404-481-2062
Practice Address - Street 1:4705 LAWRENCEVILLE HWY NW STE B
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3667
Practice Address - Country:US
Practice Address - Phone:678-691-0839
Practice Address - Fax:404-481-2062
Is Sole Proprietor?:No
Enumeration Date:2007-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64296208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics