Provider Demographics
NPI:1851337091
Name:WANG, HAO (MD)
Entity Type:Individual
Prefix:
First Name:HAO
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 1:1915 LENDEW ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7033
Mailing Address - Country:US
Mailing Address - Phone:336-275-3325
Mailing Address - Fax:336-275-5346
Practice Address - Street 1:1915 LENDEW ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7033
Practice Address - Country:US
Practice Address - Phone:336-275-3325
Practice Address - Fax:336-275-5346
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300901208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134T1Medicaid
NC89134T1Medicaid
NC2015219BMedicare PIN