Provider Demographics
NPI:1194933457
Name:WANG, MEILING (LAC)
Entity type:Individual
Prefix:MS
First Name:MEILING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:11600 ELKIN ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2835
Mailing Address - Country:US
Mailing Address - Phone:301-946-1234
Mailing Address - Fax:301-946-3632
Practice Address - Street 1:11600 ELKIN ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2835
Practice Address - Country:US
Practice Address - Phone:301-946-1234
Practice Address - Fax:301-946-3632
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDUU00265171100000X
DCAC30052171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBB30OtherBCBS OF MD PARTIC. PROV.