Provider Demographics
NPI:1982875449
Name:WANG, WEIHAN (MD)
Entity Type:Individual
Prefix:
First Name:WEIHAN
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14707 YEARLING TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3552
Mailing Address - Country:US
Mailing Address - Phone:301-251-1429
Mailing Address - Fax:
Practice Address - Street 1:15245 SHADY GROVE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3222
Practice Address - Country:US
Practice Address - Phone:301-527-1650
Practice Address - Fax:301-527-8752
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine