Provider Demographics
NPI:1841207388
Name:LAU, WAI LANG (MD)
Entity Type:Individual
Prefix:
First Name:WAI LANG
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 100224
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0224
Mailing Address - Country:US
Mailing Address - Phone:352-273-5357
Mailing Address - Fax:352-392-5465
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3725
Practice Address - Country:US
Practice Address - Phone:352-273-5357
Practice Address - Fax:352-392-5465
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY287869207RN0300X
FLME 116558207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101787300Medicaid
CT010037167CT01OtherANTHEM BCBS
CT110007263Medicare ID - Type Unspecified
CTG76771Medicare UPIN
CT1371674Medicaid