Basic Information
| Provider Information | |||||||||
| NPI: | 1114064490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DONG | ||||||||
| FirstName: | LIN-WANG | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 15TH ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806314500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703920900 | ||||||||
| FaxNumber: | 9705063796 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 15TH ST | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806314500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703920900 | ||||||||
| FaxNumber: | 9705063796 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 11/17/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 44502 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.