Basic Information
| Provider Information | |||||||||
| NPI: | 1780620161 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAN | ||||||||
| FirstName: | BANGHENG | ||||||||
| MiddleName: | BING | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 PARKWAY CENTER | ||||||||
| Address2: | STE 375 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129375700 | ||||||||
| FaxNumber: | 4129375739 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 COLUMBUS AVE | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898943077 | ||||||||
| FaxNumber: | 9898946138 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 207L00000X | 4301034238 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.