Provider Demographics
NPI:1972957710
Name:WANG, JUNAO (MD)
Entity type:Individual
Prefix:
First Name:JUNAO
Middle Name:
Last Name:WANG
Suffix:
Gender:
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:7766 HIGHWAY 65 NE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55432-2832
Mailing Address - Country:US
Mailing Address - Phone:763-205-4843
Mailing Address - Fax:612-416-2085
Practice Address - Street 1:7766 HIGHWAY 65 NE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-2832
Practice Address - Country:US
Practice Address - Phone:763-205-4843
Practice Address - Fax:612-416-2085
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN629512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry