Provider Demographics
NPI:1134381163
Name:WANG, XIAODAN (MD)
Entity type:Individual
Prefix:DR
First Name:XIAODAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2329
Mailing Address - Country:US
Mailing Address - Phone:781-690-5733
Mailing Address - Fax:508-673-6182
Practice Address - Street 1:277 PLEASANT ST
Practice Address - Street 2:PRIMA CARE
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:508-673-6182
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250533207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease