Provider Demographics
NPI:1811082860
Name:WANG, BOBBY HUNG-JEH (MD)
Entity type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:HUNG-JEH
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2312 ADA PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2502
Mailing Address - Country:US
Mailing Address - Phone:505-256-1493
Mailing Address - Fax:505-256-1492
Practice Address - Street 1:2312 ADA PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2502
Practice Address - Country:US
Practice Address - Phone:505-256-1493
Practice Address - Fax:505-256-1492
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM85-119208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics