Provider Demographics
NPI:1942384102
Name:WANG, PEI (OD)
Entity Type:Individual
Prefix:
First Name:PEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11125 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3142
Mailing Address - Country:US
Mailing Address - Phone:301-231-5222
Mailing Address - Fax:301-231-0551
Practice Address - Street 1:11125 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 303
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-231-5222
Practice Address - Fax:301-231-0551
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0601009798152W00000X
MDTA1573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist