Provider Demographics
NPI:1396736039
Name:GALE, BING WANG (MD)
Entity type:Individual
Prefix:
First Name:BING
Middle Name:WANG
Last Name:GALE
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 1:4757 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4559
Mailing Address - Country:US
Mailing Address - Phone:812-234-2289
Mailing Address - Fax:812-232-4234
Practice Address - Street 1:4757 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4559
Practice Address - Country:US
Practice Address - Phone:812-234-2289
Practice Address - Fax:812-232-4234
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200361880Medicaid
INP00932256OtherRR MEDICARE
H44225Medicare UPIN
INP00932256OtherRR MEDICARE