Provider Demographics
NPI:1740499888
Name:WANG, JOHN J (MD, MS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:WANG
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:DR
Other - First Name:JUN
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MS
Mailing Address - Street 1:56 DEPOT ST #2842
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02331-2842
Mailing Address - Country:US
Mailing Address - Phone:845-470-0370
Mailing Address - Fax:
Practice Address - Street 1:56 DEPOT ST #2842
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02331-2842
Practice Address - Country:US
Practice Address - Phone:845-470-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234124208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist