Provider Demographics
NPI:1154426500
Name:WEI, JING (MD)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:WEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-273-1701
Mailing Address - Fax:302-273-4497
Practice Address - Street 1:200 HYGEIA DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2049
Practice Address - Country:US
Practice Address - Phone:302-273-1701
Practice Address - Fax:302-273-4497
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429383207P00000X, 207Q00000X
MDD0064271207Q00000X
DEC1-0007889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018234540001Medicaid
PAP00428429OtherRAILROAD MEDICARE
I63209Medicare UPIN
PA1018234540001Medicaid