Provider Demographics
NPI:1720043151
Name:KUANG, WAYNE W (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:W
Last Name:KUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8300 CARMEL AVE NE STE 303
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3147
Mailing Address - Country:US
Mailing Address - Phone:505-433-4665
Mailing Address - Fax:888-972-9218
Practice Address - Street 1:8300 CARMEL AVE NE
Practice Address - Street 2:STE 303
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-3147
Practice Address - Country:US
Practice Address - Phone:505-433-4665
Practice Address - Fax:888-972-9218
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2006-0203208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMP00364571OtherRAILROAD MEDICARE
NM42172071Medicaid
NM42172071Medicaid
NMI30875Medicare UPIN