Provider Demographics
NPI:1205808896
Name:HWANG, WAYNE S (MD)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:S
Last Name:HWANG
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 1:1100 9TH AVE
Mailing Address - Street 2:MS: M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-341-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042197207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00356512OtherRAILROAD MEDICARE
WAUS7436474OtherAETNA SPECIALIST PIN
WA1004735Medicaid
WA7617HWOtherINDIVIDUAL BLUE SHIELD
WAMD4449WOtherALASKA MEDICARE
WA7617HWOtherINDIVIDUAL BLUE SHIELD
WAP00356512OtherRAILROAD MEDICARE
WA8809205Medicare PIN
WAMD4449WOtherALASKA MEDICARE
WAAB38496Medicare PIN