Provider Demographics
NPI:1912650029
Name:WANG, JI
Entity type:Individual
Prefix:
First Name:JI
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 VEIRS MILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1801
Mailing Address - Country:US
Mailing Address - Phone:301-279-6960
Mailing Address - Fax:301-279-6962
Practice Address - Street 1:2000 VEIRS MILL RD STE A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20851-1801
Practice Address - Country:US
Practice Address - Phone:301-279-6960
Practice Address - Fax:301-279-6962
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02884171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist