Provider Demographics
NPI:1053406421
Name:WANG, JIANHUA (MD)
Entity type:Individual
Prefix:DR
First Name:JIANHUA
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8819 COMMONS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-4102
Mailing Address - Country:US
Mailing Address - Phone:330-425-2212
Mailing Address - Fax:330-425-2779
Practice Address - Street 1:8819 COMMONS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-4102
Practice Address - Country:US
Practice Address - Phone:330-425-2212
Practice Address - Fax:330-425-2779
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-073146207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2042220Medicaid
H17526Medicare UPIN
WA4023243Medicare ID - Type Unspecified