Provider Demographics
NPI:1467844571
Name:WANG, KEVIN CHAO (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CHAO
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:862 W NEWPORT AVE
Mailing Address - Street 2:UNIT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2384
Mailing Address - Country:US
Mailing Address - Phone:317-490-5974
Mailing Address - Fax:
Practice Address - Street 1:6050 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2605
Practice Address - Country:US
Practice Address - Phone:786-584-5555
Practice Address - Fax:786-584-5050
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME169420207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine