Provider Demographics
NPI:1780601203
Name:WANG, ALINE V (MD)
Entity type:Individual
Prefix:DR
First Name:ALINE
Middle Name:V
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7425 FORSYTH
Mailing Address - Street 2:C B 8221
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2161
Mailing Address - Country:US
Mailing Address - Phone:314-362-6973
Mailing Address - Fax:314-362-1185
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-6973
Practice Address - Fax:314-362-1185
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-01-14
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Provider Licenses
StateLicense IDTaxonomies
MO2005016225207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H35458Medicare UPIN
P00278035Medicare PIN