Provider Demographics
NPI:1255588406
Name:WANG, HENG (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:HENG
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14567 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9499
Mailing Address - Country:US
Mailing Address - Phone:440-632-1668
Mailing Address - Fax:440-632-1697
Practice Address - Street 1:14567 MADISON RD
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9499
Practice Address - Country:US
Practice Address - Phone:440-632-1697
Practice Address - Fax:440-632-1697
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH81033208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2323980Medicaid