Provider Demographics
NPI:1508738113
Name:WANG, XIANGYU (RPH)
Entity type:Individual
Prefix:DR
First Name:XIANGYU
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 ASPECT DR UNIT 117
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7755
Mailing Address - Country:US
Mailing Address - Phone:929-307-7487
Mailing Address - Fax:
Practice Address - Street 1:2210 EDISON RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46615-3514
Practice Address - Country:US
Practice Address - Phone:574-472-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26031467A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist