Provider Demographics
NPI:1952347668
Name:WANG, PAUL P (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:P
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6983
Mailing Address - Country:US
Mailing Address - Phone:603-472-8888
Mailing Address - Fax:603-472-9090
Practice Address - Street 1:4 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6983
Practice Address - Country:US
Practice Address - Phone:603-472-8888
Practice Address - Fax:603-472-9090
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102218207T00000X
NH16529207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3096311Medicaid
AL1952347668Medicaid
FL000213600Medicaid
FLAK767ZMedicare PIN
H85683Medicare UPIN