Provider Demographics
NPI:1861387862
Name:WANG, QIN (NCCAOM DIPLAC)
Entity type:Individual
Prefix:
First Name:QIN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:NCCAOM DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 PROSPECT HILL DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1083
Mailing Address - Country:US
Mailing Address - Phone:725-322-9095
Mailing Address - Fax:
Practice Address - Street 1:5282 CAMPBELL BLVD STE I
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4913
Practice Address - Country:US
Practice Address - Phone:725-322-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03189171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist