Basic Information
Provider Information
NPI: 1962720284
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WANG
FirstName: JAMES
MiddleName: YU-CHENG
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2830 VICTORY PKWY
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452061785
CountryCode: US
TelephoneNumber: 5135856200
FaxNumber: 5132453672
Practice Location
Address1: 234 GOODMAN ST
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452192364
CountryCode: US
TelephoneNumber: 8593417837
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/11/2010
LastUpdateDate: 02/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X35.123952OHY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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